Localization Of The Parathyroid

ABSTRACT

Systems and methods are disclosed for locating the parathyroid. In one aspect, temporal variation among a plurality of images is evaluated and at least one image is enhanced according to the temporal variation. The image may be enhanced to one or both of reduce conspicuity of the thyroid gland and enhance conspicuity of the parathyroid gland. Some of the plurality of images may be adjusted in order to align representations of a target portions. Adjustments may be based locations of one or more organs or one or more artificial markers affixed to a living body in the plurality of images. A local positioning system (LPS), GPS, or other locating system may be used to position a living body, align the plurality of images, or to guide the positioning of objects relative to the living body. An elastomeric gel marker for imaging applications is also disclosed.

CROSS-REFERENCE TO RELATED APPLICATIONS

This non-provisional patent application is a continuation of U.S. patentapplication Ser. No. 15/808,833, filed Nov. 9, 2017, pending, which is acontinuation of U.S. Pat. No. 9,931,071, issued Apr. 3, 2018, which is acontinuation of U.S. Pat. No. 9,521,966, issued Dec. 20, 2016, whichclaims the benefit of U.S. Provisional Patent Application No. 61/648,425filed on May 17, 2012, the disclosures of which are incorporated hereinby reference in their entireties.

FIELD

This application relates to imaging of internal organs and, inparticular, to parathyroid gland localization or localization of otherorgans.

BACKGROUND

Most people have 4 parathyroid glands (some have fewer than 4 and somehave more than 4 glands). These glands lie behind the Thyroid gland inthe lower neck. They are separate from the thyroid gland. Theparathyroid gland controls Calcium levels in the bones and blood. Thereare many symptoms and problems that can be caused by an over growth orover production of one or multiple Parathyroid gland(s). Some of themost common problems caused by parathyroid abnormalities include:osteoporosis (bone loss), kidney stones, changes in Mood, fatigue, andmuscle problems.

An abnormal parathyroid gland can be imaged using radioactive Sestamibi.Technecium is a radioactive isotope that is bound to the Sestamibi.Sestamibi is a molecular compound that is taken up by abnormalparathyroid glands. Unfortunately, Sestamibi is also taken up by theThyroid gland. The thyroid uptake impedes the visualization of theparathyroid glands because of the close proximity of the parathyroidgland to the thyroid.

The systems and methods disclosed herein provide an improved approachfor visualizing the parathyroid and diagnosing parathyroidabnormalities.

SUMMARY

In some embodiments, a method for identifying a bodily structure usesnuclear medicine image information acquired and compared over differenttime intervals in order to compare separate images using only oneisotope. Some embodiments use identified target organs to align bodystructures and assess their three dimensional location based on acquireddata based on a two dimensional projection with a modified or modulatedor subtracted Nuclear medicine image. Specifically this technique can beuseful and be applied to include but not restricted to Parathyroid glanddetection imaging.

In most patients the thyroid activity diminishes over time. A normalparathyroid gland will take up Sestamibi early but the activitydiminishes over time. The abnormal parathyroid gland will take upSestamibi early and continue to accumulate Sestamibi over approximately30 to 180 minutes, after which the Sestamibi activity will alsodiminish.

In an attempt to separate the thyroid activity from the parathyroidactivity a technique was developed in the past where both radioactiveiodine and Sestamibi Technecium are injected into the blood stream.Iodine is taken up by the thyroid and not the parathyroid. The Sestamibiis taken up by both. This technique is limited by the overlappingactivities of the two isotopes and has the disadvantage of subjectingthe patient to added radiation.

Post processing digital subtraction techniques have been previouslyutilized in medicine. One example is performing a CT scan (ComputerizedTomogram) and a Sestamibi exam. The two images are superimposed andanatomy is combined with Sestamibi uptake to attempt to localize theabnormal parathyroid gland. The limitation of this approach is that itincreases the radiation dose to the patient significantly and theradioactive localization is not improved by the CT scan.

Nuclear Medicine SPECT imaging utilizes only the initial sestamibiinjection but is limited because the sestamibi Tc is usually viewed atonly one point in time with computed tomography (CT) and if more viewsor temporal interrogations are performed using both CT and nuclearmedicine (NM), then the patient is exposed to significant amountsincreasing radiation.

A technique that can digitally subtract the Sestamibi radioactivity overa time period and distinguish thyroid from parathyroid activity would bebeneficial in parathyroid imaging, especially if it can be performedwith mathematical post-processing without subjecting the patient toadded radioactivity.

For example, in some embodiments, a sestamibi scan is performed byplacing the patient under a Nuclear Medicine camera that accumulates andrecords the activity emitted from the body. This can then be used tocreate a tomographic, 3-D or 2-D image of the body. A region of interest(ROI) or field of view (FOV) refers to the part of the body that isinterrogated during the study.

In addition to the thyroid and the parathyroid, other organs of the bodytake up sestamibi. These include salivary glands, nasal mucosa, heart,liver, the spleen. Each of these organs may lie within a different siteand plane of the body. Some embodiments use the different vital organsas reference points in the body. By using these reference points, thebody can be aligned using either 3-D or 2-D modeling. External referencepoints can also be utilized.

A patient can be repositioned on a table or kept in the same locationduring the scan. In either situation, the reference points can then beused to realign the patient to a similar position or to adjust patient'simages and detected activity with post processing. In some embodiments,the reference points are used to both align the patient and detectedimages and activity of the patient.

The activity can be viewed not only as an anatomic map but also astemporal maps. The temporal and the anatomic map can be used separatelyor together to detect activity that diminishes over time. The thyroidactivity that diminishes over time can be subtracted and the parathyroidactivity that increases over time can be enhanced. Similar activity orvariable activity can be modeled appropriately to reflect patternsmanifested by the parathyroid and thyroid.

In some embodiments, the anatomic map will be created by aligning insuccessive images one or more of the salivary glands, nasal mucosa,heart, liver, the spleen and the thyroid. External markers can also beplaced anterior, posterior, and on the right and left sides or anycombination of the above.

The anatomic map of activity will be examined over time and thedifferences in activity be subtracted, added, or otherwise enhanced,using, for example, linear or nonlinear mathematical methods of analysisand correction in combination with use of one or more of internal orexternal sensors and radioactive or non-radioactive devices. Thistechnique differs from other mathematical correction processes in thatother techniques utilize a target organ such as the heart or brain asthe primary if not the sole source for image correction. In thetechniques disclosed herein, a non-target image correction may be eitherpredominantly or equally weighted with the target image. The targetorgan may be one of many radioactive sites that are used to correct forimage alignment and accuracy. In addition to using radioactivity, someembodiments may use radioactive and non-radioactive sources such thatimage alignment and correction can include but are not restricted toexternal or internal sensors.

In some embodiments, the thyroid and the parathyroid activity can bedistinguished and separated from each other using the methods disclosedherein. Activity will decrease in the thyroid and increase in theabnormal parathyroid gland for most patients over time. The thyroidactivity can therefore be identified and subtracted out. The activitythat remains will be the parathyroid activity. Methods of modeling theactivity subtracted can include but are not restricted to simplesubtraction, modulating the value given to subtracted regions based ongeometric location or activity changes or a combination of the above.

For many patients, early imaging of the parathyroid is masked by higherradioactivity count rates in the thyroid. Over time, the thyroidactivity theoretically decreases to a level low enough that theparathyroid activity will become greater than the thyroid activity.Although this event occurs in this manner in many patients, thisphenomenon does not occur in a significant number of patients. In about30 to 50% of patients the thyroid and the parathyroid activity can beoverlapping or the thyroid radioactivity does not reduce sufficiently toyield a confident diagnosis for a parathyroid adenoma. In order toincrease the confidence of the abnormal parathyroid diagnosis andimprove the conspicuity between the thyroid activity and the parathyroidactivity, imaging methods disclosed herein can be applied to overcomethe limitations of persistent thyroid activity.

One method uses Tc-99 Sestamibi as the diagnostic isotope. A nuclearmedicine camera device assigns regions of interest (ROI) or pixels tothe body. This information is collected at different points in time (atemporal data set or temporal map). These data sets can be compared. ARegion of Interest (ROI) is assigned a value and depending on theincrease or decrease in that ROI the pixel can include but notrestricted to be amplified, remain the same, diminished or modulated bya mathematical model in relationship to but not restricted to thepresent, future or the past images or the adjacent pixels or data sets.

One embodiment can include but is not restricted to an activitycorrection method where the thyroid exhibits an increase in activityafter the first few seconds to minutes after administering aradioisotope. This increase in activity can then be used to identify aregion that is designated as thyroid. Over time the normal thyroidactivity will then diminish. One embodiment can include but is notrestricted to a method where the removal of all activity in the thyroidneck region that is diminishing at a given threshold rate or at a giventime interval or period is assumed to be thyroid activity. Oneembodiment can include but is not restricted to a method where all ormost of the diminishing activity over time can then be added orsubtracted from the image in a manner to include but not restricted toall or a portion of the activity in a manner to include but notrestricted to the data being altered using a using a mathematical modelthat modulates the data by a method to include but not restricted to alinear or nonlinear or a variable or non-variable manner.

A mathematical model may be used that modulates the data by a method toinclude but not restricted to a linear or nonlinear or a variable ornon-variable manner. In some embodiments, the abnormal parathyroidactivity, which increases over time either in an absolute or relativemanner relative to the thyroid activity can then be better imaged afterdeducing the thyroid activity. One embodiment can include but is notrestricted to a method where all increasing absolute or relativeactivity can also be amplified after a specific target threshold time inconjunction with subtracting or reducing all diminishing activity, whichis assumed in this model to be thyroid activity. In this embodiment theamplification of increasing activity the parathyroid will become moreconspicuous compared to the decreasing thyroid activity, which willbecome less conspicuous. One embodiment can include but is notrestricted to a method where the relative levels at which the valuesamplified or diminished can be adjusted or modulated upward or downwardby filters that are absolute or relative and can have variable curves toinclude but are not restricted to non-linear, linear, or Gaussian,exponential curve filters, or any combination of these or other filters.The resulting temporal data map may make the assumption that theincreasing activity is presumably parathyroid, and the decreasingactivity is thyroid. The amplified activity when viewed in relation tothe background of relative decreasing activity, presumably thyroid, mayadvantageously yield greater conspicuity between the parathyroid and theparathyroid glands then the raw data images.

Computer-aided drafting (CAD) software can be utilized to assist in thedefining or locating of the target organ by altering orenhancing/increasing or diminishing or attenuating the intensity of therepresentation of information or activity and this can be performed bythe computer or by a living creature in a mechanical or an automatedmanner. In some embodiments an area to include but not restricted to athyroid nodule or an area of the thyroid that is thicker or has morevolume than other areas within the thyroid and this may appear moreintense and be confused with parathyroid activity. The computer orliving creature can alter the data or the representation of the data orimage by altering or increasing or enhancing or decreasing orattenuating a given area of the data.

Some imaging methods may include receiving, by a computer system, aplurality of image frames representing received radiation from a regionof interest within a living body at a series of time points. The imagesmay be received subsequent to administering a radioisotope, such as Tc99Sestamibi. A computer system evaluates temporal variation among theplurality of image frames. The computer system may generate an enhancedframe according to the evaluation of temporal variation by modifying anoriginal frame of the plurality of image frames effective to enhancevisibility of one or more target features of the one or more features inthe enhanced frame. The computer system may store, display, or transmitfor display to a display device, the enhanced frame for display.

Computer systems disclosed herein may include any computer system knownin the art, such as a computer system having one or more processorsoperable to process executable and operational data and one or morememory devices operably coupled to the one or more processors. The oneor more processors may store executable and operational data effectiveto cause the one or more processors to perform any or all of the methodsdescribed herein.

The computer system may modify the original frame effective to enhancevisibility of one or more target features by adjusting in a first mannerone or more first portions of the original frame having a first temporalvariation pattern relative to a reference intensity; and adjusting in asecond manner one or more second portions of the original frame having asecond temporal variation pattern relative to the reference intensity.The one or more first portions may correspond to parathyroid glands ofthe living body and the one or more second portions may correspond to athyroid gland of the living body.

The computer system may be configured to adjust the one or more firstportions in the first manner and adjust the one or more second portionsin the second manner by applying a temporal filter to the plurality ofimage frames. For example, the temporal filter may include one or moreof a linear filter, non-linear filter, Gaussian filter, and exponentialcurve filter. Generating the enhanced frame according to the evaluationof temporal variation may include modifying the original frame accordingto application of a mathematical model to the plurality of image frames.

In some embodiments, the computer system is configured to generate theenhanced frame according to the evaluation of temporal variation bymodifying the original frame according to temporal variation of areference feature in the plurality of image frames. The referencefeature may include a representation of radiation emitted by anartificial or non-organic structure affixed to the living body. In someembodiments, the artificial structure has a known decay rate andmodifying the original frame according to temporal variation of thereference feature of the one or more features may include correctingmeasured activity for one or more portions of the original frameaccording to measured activity for the artificial structure and theknown decay rate.

In some embodiments, the computer system is configured to identify arepresentation of a thyroid of the living body in the plurality of imageframes by identifying in the plurality of image frames portions showingan initial increase in activity relative to reference activity apparentin the plurality of image frames followed by a decrease in activitymeeting a condition with respect to the reference activity. The computersystem may then be configure to generate the enhanced frame according tothe evaluation of temporal variation by altering the representation ofthe thyroid in the enhanced frame.

In some embodiments, the computer system is configured to identifyrepresentations of a thyroid gland in the plurality of image framesaccording to temporal variation of the representations of the thyroidgland in the plurality of image frames generates the enhanced frame byadjusting a representation of the thyroid gland in the enhanced frameeffective to enhance the conspicuity of the one or more representationsof the one or more parathyroid glands. This may include reducingintensity of the representation of the thyroid gland or otherwise makingthe representation of the thyroid gland less visibly distinct in theenhanced image.

In some embodiments, the computer system may be configured to identifythe one or more representations of the one or more parathyroid glands inthe plurality of image frames according to temporal variation of the oneor more representations of the one or more parathyroid glands in theplurality of image frames. The computer system may further be configuredto generate the enhanced frame by adjusting the representations of theone or more parathyroid glands in the selected frame to enhanceconspicuity of the representations of the one or more parathyroidglands. The computer system may identify the representation of the oneor more parathyroid glands in the plurality of image frames byidentifying increasing activity of the representations one or moreparathyroid glands relative to the reference activity represented in theplurality of image frames.

In some embodiments, the computer system is configured to identify theone or more representations of the one or more parathyroid glands in theenhanced frame, identify a representation of the thyroid gland in theenhanced frame, and evaluate one or more locations of the one or morerepresentations of the one or more parathyroid glands relative to therepresentation of the thyroid in the enhanced frame. The computer systemmay be configured to characterize health of the one or more parathyroidglands according to the evaluation of the locations of the one or moreparathyroid glands. For example, evaluating the one or more locations ofthe one or more representations of the one or more parathyroid glandsmay include evaluating asymmetry of the one or more locations of the oneor more representations of the one or more parathyroid glands relativeto the thyroid; atypical positioning of the one or more locations of theone or more representations of the one or more parathyroid glandsrelative to the thyroid; and eccentric positioning of the one or morelocations of the one or more representations of the one or moreparathyroid glands relative to the thyroid.

An alternative imaging method may include administering a radioisotopeto a living body. A computer system may be configured to receiver from adetector, such as any of the imaging systems discussed herein, anoriginal image representing received radiation from a region of interestwithin the living body subsequent to administration of the radioisotope.A first treatment may be administered to the living body subsequent toadministering the radioisotope, the first treatment effective to reduceactivity in one or more parathyroid glands of the living body. The firsttreatment may be administered after detecting the original image.Alternatively, the first treatment may be administered prior todetecting the original image such that the effect of the first treatmentis not apparent in the original image. The computer system may beconfigured to receive from the detector, a confirmation frame, theconfirmation frame representing received radiation from the region ofinterest within the living body subsequent to administering the firsttreatment. The computer system may then be configured to compare theconfirmation frame to the original frame and identify as one or morerepresentations of the one or more parathyroid glands those portions ofthe enhanced frame that have high apparent activity and for whichcorresponding portions in the confirmation frame have reduced apparentactivity. In some embodiments, one or both of the original frame andconfirmation frame may be enhanced according to some or all of themethods disclosed herein. The first treatment may include a treatmenteffective to reduce activity of the parathyroid, such as reducing uptakeof the radioisotope. For example, the first treatment may include atleast one of non-radioactively labeled sestamibi, calcium, a calciumchannel blocker, and an agent that alters the sensitivity of the sensingreceptors or the uptake activity in the parathyroid, such as cinacalcet(Sensipar™).

In some embodiments, an imaging method includes administering a firsttreatment to a living body, the first treatment operable to alterfunctioning of a first organ of the living body. One or more images maythen be generated of at least a portion of the loving body using a firstimaging modality. The one or more images may be enhanced and/or analyzedaccording to any of the methods disclosed herein. The first treatmentmay be effective to enhance conspicuity of a target portion of theliving body due to the altering of the functioning of the first organ.The target portion may be a second organ of the living body differentfrom the first organ or may be the first organ. For example, the firstorgan may be a parathyroid gland or a thyroid gland. The first treatmentmay be operable to affect, e.g. increase, blood flow to the first organ.The first treatment may additionally or alternatively be operable toaffect uptake of a substance, e.g. Tc-99 Sestamibi that enhancesvisibility of the first organ in the first imaging modality.

In some embodiments, the first treatment is at least one ofhydrochlorothiazide, calcium, calcium channel blocker, an agent thatalters the sensitivity of the sensing receptors or activity or uptake inthe parathyroid (e.g. cinacalcet), and an inorganic phosphate andaffects blood flow in the parathyroid. In other embodiments, the firsttreatment affects blood flow to the thyroid and is at least one ofpropylthiouracil, methimazole (Tapazole), thiourea, thiouracil, and aderivative of at least one of propylthiouracil, methimazole (Tapazole),thiourea, iodine, and thiouracil. In some embodiments, the firsttreatment affects uptake of a first substance by the thyroid. Forexample, the first treatment may be a thyroid agent including at leastone of propylthiouracil, methimazole (Tapazole), thiourea, thiouracil,iodine, a thyroid 2 stimulating hormone (TSH), a thyroid 2 releasinghormone (TRH), a TSH blocking agent, a TRH blocking agent, or aderivative of the thyroid agent. In some embodiments, the firsttreatment is effective to affect calcium uptake by the first organ. Insome embodiments, the first treatment includes one of adding andwithdrawing energy from the organ.

A second feature of this embodiment can include but is not restricted toa localization method where the alignment of the thyroid and theparathyroid can be improved by registering body structures that take upand transmit the radioactivity, the Tc 99 Sestamibi, to include but notrestricted to the salivary glands, the heart, the liver and activeradioactive markers. These structures are distributed at differentlocations within the body and have a three-dimensional relationship inthe body. These localizing structures can be chosen to include but arenot restricted to body structures that do not significantly change theirrelative position in the body during the course of the scan. Even thoughthe localizing structures activity may vary during the scan, theabsolute or relative activity is not the issue and it is the location ofthe structure and of its activity that is most pertinent to aligning thebody parts using a method to include but not restricted to twodimensional (2-D) or three dimensional (3-D) modeling or a combinationof both 2-D and 3-D modeling. By aligning these localizing structures apatient can thus move around or even be removed from and then returnedto the scanner and the image can still be aligned even if the patientmoves between scans. One embodiment can include but is not restricted toa method where the data is realigned using a mathematical correction forpositioning utilizing the expected 3-D location which is then transmutedinto a 2-D location of the structures to compensate for misalignmentsbetween scans. In one embodiment the liver and spleen and salivaryglands and heart can be used as internal markers of alignment. Anexternal marker can be affixed to the body. A mathematical model can beused to assess the movement or the rotation of each of these organs ormarkers. Mathematical modeling can utilize but is not restricted to edgedetection, step detection, edge thinning, using a Kirsch operator, pixelor voxel realignment which can include but is not restricted tomeasuring the number of pixels or voxels or both and comparing theincrease or decrease in the number of pixels or voxels in any directionand correcting the movement to align or change in position to or withthe original or propositus image. This process can be performed once ormore than once to fine-tune or adjust the static target locations. Thismethod can be combined with other methods that provide for imagealignment or re-alignment, including but not restricted to ComputedTomography (CT), Ultrasound (US), Photo-Acoustic imaging (PAI), MagneticResonance Imaging (MM), Thermography, or other imaging and/orpositioning techniques.

One embodiment can include but is not restricted to a method where thealignment can be augmented using three-dimensional mathematical modelingof either the target organs, to include but not restricted to thethyroid and parathyroid or the non-target organs to include but notrestricted to the salivary glands, the heart, and the liver or activenuclear radioactive markers.

Another embodiment can include but is not restricted to a method wherethe radioactivity of the non-target organs can be standardized andcorrectional computations performed based on an increase or decrease inradioactive activity over time and then compare this increase ordecrease in activity to but mot restricted to the target organ (e.g.thyroid and parathyroid glands).

Another method can use but is not restricted to the use of externalradioactive markers, which can be standardized and the rate of decaymeasured and used to correct for target and non-target organ correctionsor location and activity.

Another method can use but is not restricted to the use of externalradioactive markers, which can be used as localizing markers by whichalignment can be augmented or achieved and can be combined with otheralignment methods to include but not restricted to alignment of thetarget and non-target organ corrections or location and activity.

One embodiment can include but is not restricted to a method where theradioactivity is acquired in a continuous or discontinuous method or acombination of continuous or discontinuous.

One embodiment can include but is not restricted to a method where theactivity correction method, the localization method or a combination ofthe activity correction method and the localization method and othercurrently utilized methods that can use and include but is notrestricted to CT, MRI, US, PAI, Thermography or other imagingtechniques.

One embodiment can include but is not restricted to a method where thelocalization is performed with electro-magnetic radiation to include butnot restricted to near infra-red, infra-red, ultraviolet andthermographic imaging device. Thermography can be used to imageparathyroid locations. In one embodiment the patient can be repositionedon the table in the same position by using a method that includes but isnot restricted to thermography, heat or near infra-red, infra-redimaging or a combination of the above.

One embodiment can include but is not restricted to a method where thelocalization is performed with kinetic or ultrasound or mechanical orelectro-magnetic energy alone or in combination to include but notrestricted to near infra-red, infra-red, ultraviolet and thermographicimaging device, ultrasound, mechanical localization or fixation.

In one embodiment the patient can be repositioned on the table in thesame position by using a method that includes but is not restricted tothermography, heat or near infra-red, infra-red imaging or a combinationof the above.

In another embodiment the heat sensitive method for localization can beapplied using a superimposed thermographic acquisition or image and thenuclear medicine radioactivity image can be corrected using a method toinclude but not restricted to mathematical correction, filtercorrection, position correction.

In another embodiment the electro-magnetic sensitive method forlocalization can be applied using but not restricted to a superimposedthermographic acquisition or image and the nuclear medicineradioactivity image can be corrected using a combination of methods toinclude but not restricted to mathematical correction, filtercorrection, position correction and the embodiment where the patient canbe repositioned on the table in the same position by using a method thatincludes but is not restricted to thermography, heat or near infra-red,infra-red imaging or a combination of the above.

In another embodiment a heat sensitive method to include but notrestricted to thermography or near infra-red, infra-red detection can beapplied for localizing abnormal parathyroid glands. Heat sensitivemethods are based on the fact that pathological parathyroid glands havea high blood flow rate and an increased metabolism that producesincreased heat which can be detected by instruments that include but arenot restricted to thermographic or near infra-red, infra-red sensitivedetection devices. These thermographic or infra-red methods anddetectors can be used alone or in combinations with other imagingdetection or localizing devices to be used to include but not restrictedto identify the location of an abnormal dysfunctioning parathyroid orthyroid gland, assist in registration and alignment of body structure,treatment of abnormal thyroid or parathyroid structures or anycombination of these organs or techniques or methods.

In another embodiment a calcium detection method to include but notrestricted to NMR, Functional magnetic resonance, or magnetic resonanceimaging spectroscopy detection can be applied for localizing abnormalparathyroid glands. The calcium sensitive methods are based on the factthat pathological parathyroid glands have a high blood flow rate and anincreased calcium detection or binding or metabolism that producescalcium localization which is absolute or relative to surrounding tissuewhich can be detected by instruments that include but are not restrictedto 3-D or 2-D US, MRI, Nuclear Magnetic resonance (NMR), Functionalmagnetic resonance, or magnetic resonance imaging spectroscopy detectionsensitive detection devices and Nuclear Medicine SPECT. These NMR,Functional magnetic resonance, or magnetic resonance imagingspectroscopy detection methods and detectors can be used alone or incombinations with other imaging detection or localizing devices to beused to include but not restricted to identify the location of anabnormal dysfunctioning parathyroid or thyroid gland, assist inregistration and alignment of body structure, treatment of abnormalparathyroid or thyroid or structures or any combination of these organsor techniques or methods.

In some embodiments, an imaging method may be performed by a computersystem and include receiving by a computer system, a plurality of imageframes, the plurality of image frames representing received radiationfrom a region of interest within a living body at a series of timepoints. Representations of one or more organs and locations thereof areidentified by the computer system in the plurality of image frames. Aplurality of adjusted frames based on the image frames may be generatedby the computer system, where the one or more of the adjusted frameshave been transformed relative to corresponding image frames of theplurality of image frames according to the locations of therepresentations of the one or more organs in the corresponding imageframes. In some embodiments, the adjusted frames may then be enhancedaccording to some or all of the image enhanced methods disclosed herein.The adjustment of the image frames may advantageously facilitateevaluation of temporal variation among frames by ensuring that theportion of the adjusted images corresponding to a target area arealigned with one another.

In some embodiments, the computer system is configured to generate theplurality of adjusted frames based on the plurality of image frames byidentifying expected three-dimensional locations of the one or moreorgans based on the plurality of image frames and calculatingtwo-dimensional locations for the one or more organs in the plurality ofadjusted image frames based on the expected three-dimensional locations.

In some embodiments, the computer system is configured to generate theplurality of adjusted frames based on each frame of the plurality ofimage frames by identifying first locations of the representations ofthe one or more organs in the each frame and identifying secondlocations of the representations of the one or more organs in a frameother than the each frame in the plurality of image frames. The computersystem may be configured to generate the adjusted frame of the pluralityof adjusted frames corresponding to the each frame according to atransformation based on the first locations and the second locations.

The one or more organs may perform uptake of a radioisotope. Forexample, the received radiation from the region of interest may be inresponse to administration of Tc99m-sestamibi to the living body. Theorgans may also have relatively fixed locations within the living body.For example, the one or more organs may include one or more of thesalivary glands, nasal mucosa, heart, liver, and spleen of the livingbody.

In another imaging method, a radioisotope is administered to a livingbody and one or more radioactive markers are affixed relative to theliving body. A computer system receives a plurality of image frames, theplurality of image frames representing received radiation from theradioactive markers and from within the living body at a series of timepoints. The computer system is configured to identify one or morereference features and the locations thereof in the plurality of imageframes, where the one or more reference features corresponding to theradioactive markers. The computer system may be further configured togenerate a plurality of adjusted frames based on the image frameswherein one or more of the adjusted frames have been transformedrelative to corresponding image frames of the plurality of image framesaccording to the locations of the one or more reference features in thecorresponding image frames.

In some embodiments the computer system may be configured to generatethe adjusted frames based on the locations in the image frames of boththe reference features and representations of one or more organs asdescribed above. The methods whereby the image frames are adjusted basedon the locations of the reference features, or both the referencefeatures and the one or more organs, may be as described above withrespect to using the locations of organs to generate adjusted imageframes. Likewise, the adjusted frames based on the reference featuresmay be enhanced and/or analyzed according to any of the methodsdescribed herein.

The radioactive markers may be affixed to the surface of the livingbody, to a frame secured to the loving body, or implanted within theliving body.

One embodiment can include but is not restricted to a method where thelocalization and positioning of the patient is performed with a GlobalPositioning Satellite Tracking Device (GPS). The GPS can be positionedonto the patient in one or more locations. In one embodiment the GPSdevice can be affixed directly to the body using various methods toinclude but not restricted to adhesive, tapes, elastic, cloth, can beinjected or implanted and Velcro In another method the GPS device can beaffixed indirectly to the body using a method to include but notrestricted to a garment, a mask, a frame, a helmet, or an apparatusdesigned to mold to a body part. The direct and the indirect methods canbe used alone or in combinations.

One embodiment the GPS device can be used but is not restricted assistin patient positioning. This method can be used to include but notrestricted to assist radioactivity and thermography correction andlocalization methods by more precisely superimposing the body structuresand providing for more accurate image correction. The GPS can be usedfor correction methods and for localization method or a combination ofthe correction method and localization method. The GPS method can beused with currently utilized methods for image creation and quantitativeand qualitative methods that can include but not restricted to CT andPET or correct quantitation to include but not restricted to Gaussian,linear or exponential curve filters.

One embodiment can include but is not restricted to a method where thelocalization and positioning of the patient is performed with a systemthat shall be referred to as a Local Positioning Tracking Device (LPS).A mobile or fixed coordinate location device replaces the transmittersand receivers or satellite-substitute coordinate locators in a spacethat surrounds the object or patient or body being interrogated.

LPS is an imaging system that can be isolated from the outer environmentand from radiofrequency signals. On method for isolating the LPS devicecan include a room lined with a material that prevents the influx ofelectromagnetic waves to include but not restricted to radiofrequencywaves (RF). One method to isolate the room and the LPS system from theouter environment can include but is not restricted to lining the roomwith materials that can include but are not restricted to copper thatbehave as a barrier to the random influx of these wave and is referredto as a Faraday cage.

In some embodiments, a method for imaging may be performed by a computersystem and include receiving a plurality of image frames, the pluralityof image frames representing received nuclear radiation from a region ofinterest within a living body at a series of time points. The method mayfurther include receiving, by the computer system, for each frame of atleast a portion of the plurality of image frames, a secondarymeasurement of the living body corresponding to the each frame. Thecomputer system may generate a plurality of adjusted frames based on theplurality of image frames by transforming at least a portion of theplurality of image frames according to the secondary measurements of theliving body corresponding to the at least a portion of the plurality ofimage frames. The adjusted images may be enhanced and/or analyzedaccording to the methods described herein.

In some embodiments, the computer system may be configured to transformthe at least a portion of the plurality of image frames according to thesecondary measurements by, for each frame of the at least a portion ofthe plurality of image frames identifying one or more first referencemeasurements from the secondary measurement corresponding to the eachframe; identifying one or more second reference measurements from thesecondary measurement corresponding to a frame other than the each framein the plurality of image frames; and generating the adjusted frame ofthe plurality of adjusted frames corresponding to the each frame basedon the first and second reference measurements.

The secondary measurements may be received from GPS or LPS positioningreceivers affixed to the living body or embedded therein. Secondarymeasurements may be received from a camera having the region of interestin a field of view thereof. The camera may detect light in the visualspectrum, infrared (e.g. thermographic), near-infrared, or some otherspectrum. In some embodiments, the secondary measurements may includemeasurements of translucence of the loving body for one or morewavelengths or wavelength ranges. Secondary measurements may also beperformed using a mechanical measuring means, magnetic resonanceimaging, ultrasound, PAI, X-ray, computed tomography, positron emissiontomography, single-photon emission computed tomography, or some otherimaging modality.

The local LPS coordinate location works similar to ones used in asatellite position in that it is set by the position of the locator inspace and the position and distance from each other is a known entity.Each locator has the capacity to send and/or receive and shall bereferred to as a locator. By knowing the position of each locator acoordinate system can be created relative to the space created by saidlocators. When an object is placed in the coordinate system the preciselocation of that object can be determined relative to that coordinatesystem by placing locators onto the target object or body or body part.

An LPS receiver calculates its position by precisely timing the signalssent by LPS devices strategically placed around the target which caninclude but is not restricted to the patient being imaged. Each LPSdevice continually transmits messages that include, the time the messagewas transmitted and the precise positional information of the LPS devicethat substitutes for the ephemeris in a GPS device. The LPS receiver orreceivers which are positioned relative to the target that can includebut is not restricted to the patient's body or a body part of thepatient uses the signals it receives to determine the transit time ofeach signal and computes the distance from each LPS transmission device.These distances along with the LPS transmission devices locations arecalculated using an algorithm to include but not restrictedtriangulation, trilateration, depending on which algorithm is used, tocompute the position of the receiver. The position to include but notrestricted to the body or body part is then displayed on a display thatcan include but is not restricted to a body profile, a schematic of thebody, a moving map, a Cartesian map, a display with latitude andlongitude and elevation, a display with cranial caudal andanterior-posterior position, The display can include but is notrestricted to displaying animated information, an x-ray, CT, PET scan,Nuclear Medicine, Ultrasound, PAT, Thermographic or optical image orimaging system and that image can display information to include but notrestricted to anatomic information, physiologic information,radioactivity, instrumentation information, human information to includebut not restricted to receivers or transmitters on the hands, fingers,surgical tools and the information displayed can include but is notrestricted to movement, speed, direction, and change in position.

In some embodiments four LPS transmission devices are optimal but thenumber of LPS transmission devices can be more than or fewer than fourLPS transmission devices. Fewer than four LPS transmission devices canbe used if the LPS receiver knows its position which can include but isnot restricted to a fixed receiver on or in the body or body part thatserves as an absolute or relative position in reference to the body.

One embodiment, can include but is not restricted to determining alocation using a mathematical method such as lateralization using theLPD transmitters that can be on the body in the body, external to thebody or any combination of on the body in the body, and external to thebody.

In one embodiment a method is used for correcting for the speed of lightwhich is a large value to include but not restricted to a method usingan atomic clock that is as accurate as can be manufactured. In anothermethod a solution for correcting for clock error can include but are notrestricted to using additional antenna or transmitters whose spheres orsignals intersect to include but are not restricted to a control signalor sphere or surface or computational or constructed fixed coordinate orcoordinates.

In another embodiment, the receiver can be constructed to exceedstandard bit speeds of 4,800 bit/sec and can use protocols that do notrequire large ranges but can focus on small areas. By not utilizingstandard GPS this would provide a method that was in compliance with USGovernment controls. Also by placing the transmitters below theionosphere one of the major causes of delay can be bypassed.

Another embodiment can include but is not restricted to one or multipleLPS devices. Another embodiment can include but is not restricted to oneor multiple GPS devices. Another embodiment can include but is notrestricted to a combination of one or multiple LPS and GPS devices.

Another embodiment can include a method for correcting for error if aGPS device is used. An error can occur secondary to delay in signaltransmission through the ionosphere. More than one transmittingfrequency can be used to correct for ionosphere error by comparingcapture rates for each frequency.

Another embodiment can include but is not restricted to using a moreprecise method called Carrier-Phase Enhancement (CPGPS), which correctfor any incongruity between the phase and can use an additional clockusing a method to include but not restricted to the L1 carrier wavewhich can correct for non-instantaneous imperfect correlation oftransmitter-receiver correlation.

Another embodiment can include a method for precision that can includebut is not restricted to Relative Kinematic Positioning (RKP).

Another embodiment can include a method for precision that can includebut is not restricted to using a clock that is not synchronized toCoordinated Universal Time (UTC), a method that is synchronized to GPStime, a method that is independent of GPS time and UTC (Non-UTC andnon-GPS; independent coordinated time (ITC); International Atomic Time(TAI) or any combination of TAI, UTC and GPS and ITC.

In one embodiment ITC can be a time that is set independent of allstandards and is used only for the local LPS.

Another embodiment can include a method for precision that can includebut is not restricted to knowing the precise distance between thetransmitters, receivers or a combination of transmitters and receivers.This precise distance can be determined using methods to include but notrestricted to lasers, ultrasound, and electromagnetic measuring devicesand other methods for measurement to include but not restricted tokinetic physical measuring techniques to include but not restricted torulers.

Knowledge of the fixed distance between transmitters, receivers orcombination of transmitters and receivers can be used to set the clockor distance or precision of location more precisely and can be used toeliminate or reduce errors to include but not restricted to the partialwavelength, wavelength off-set, time incongruence, mathematicalassumptions or any combination of these errors.

Another embodiment to include but not restricted to synchronizing thereceiver and the transmitter clocks using methods to include but notrestricted to one or multiple wavelength sampling and correlation andcomparing these wavelengths, tuning the clocks using a method to includebut not restricted to using the known distance between the fixedreceivers and transmitters to synchronize and correlate time anddistance using one or multiple wavelengths, lasers, or otherelectromagnetic or non-electromagnetic measuring tools. Some embodimentsmay include but is not restricted to triple differencing which subtractsthe receiver differences from Time A compared to that of Time B. In oneembodiment the triple difference method can use three independent timepairs to solve for a receivers location position.

The LPS can be positioned onto the patient in one or more locations. Inone embodiment the LPS device can be affixed directly to the body usingvarious methods to include but not restricted to adhesive, tapes,elastic, cloth and Velcro, In another method the GPS device can beaffixed indirectly to the body using a method to include but notrestricted to a garment, a mask, a helmet, or an apparatus designed tomold to a body part to include but not restricted to caps, frames,bands, garments. An external source can also be attached to the bodyusing methods of attachment to include but not restricted to adhesives,bandages, membranes, injections into the skin, sutures in the skin,bands and Velcro and straps, earrings, tattoos, and skin-piercings orinternal and external methods can be used and combined to include butnot restricted to swallowed, inhaled, injected, place onto, into orthrough the skin or mucosa or an orifice.

One embodiment the LPS device can be used but is not restricted assistin patient positioning. This method can be used to include but notrestricted to assist radioactivity and thermography correction andlocalization methods by more precisely superimposing the body structuresand providing for more accurate image correction. The LPS can be usedfor correction methods and for localization method or a combination ofthe correction method and localization method. The LPS method can beused with currently utilized methods for image creation and quantitativeand qualitative methods that can include but not restricted to CT andPET or correct quantization to include but not restricted to Gaussian,linear or exponential curve filters.

In some embodiments, an LPS system includes a plurality of staticcomponents distributed in fixed locations relative to one another abouta living body and at least one locator component affixed relative to theliving body, the plurality of static components and locator componentsbeing operable to communicate effective to define a location of the atleast one locator component. A computer system is in data communicationwith at least one of the plurality of static components and the at leastone locator component. The computer system may be configured todetermine a location of the locator components from one or more outputsof one or both of the plurality of static components and the at leastone locator component.

In some embodiments, the one or more outputs include at least one staticcomponent output from the plurality of static components and the atleast one locator component is operable to transmit signals. Theplurality of static components may be operable to detect the signals andproduce the static component output representing a location of the atleast one locator component.

In some embodiments, the one or more outputs include at least onelocator component output from the at least one locator component;wherein the plurality of static components are operable to transmitsignals; and wherein the at least one locator component is operable todetect the signals and produce the locator component output representinga location of the at least one locator component.

In some embodiments, the plurality of static components and the at leastone locator component are both operable to communicate with one anotherby transmitting and receiving signals.

In some embodiments, the plurality of static components and the at leastone locator component are positioned within a device that can shield abody or body part or space from external electromagnetic signals orenergetic or mechanical signals that can interfere with the precision ofthe LPS system and in one embodiment can be composed of copper and inthis embodiment can be referred to as a faraday cage. The faraday cagemay conform to a head of the living body. In some embodiments, thefaraday cage is coextensive with a plurality of walls of a room.

In some embodiments, the at least one locator component is fastened to asurface of the living body.

In some embodiments, the computer system may be configured to direct aninstrument to administer a treatment to the living body based on thelocation of the at least one locator component.

In some embodiments, the at least one locator component has enhanceddetectability in a non-visual imaging modality. The LPS system mayinclude an imaging system operable to image the living body in thenon-visual imaging modality. The computer system may be operably coupledto the imaging system and be configured to relate a first portion of animage generated according to an output of the imaging system to thelocation of the at least one locator component based on at least onesecond portion of the image corresponding to the at least one locatorcomponent.

In some embodiments, the at least one locator component is at least onefirst locator component and the LPS system further includes at least onesecond locator component affixed to an object and in data communicationwith the computer system. In some embodiments, the computer system isconfigured to detect a relative position of the at least one firstlocator component relative to the at least one second locator componentaccording to the one or more outputs.

In some embodiments, the computer system is further configured tocontrol positioning of the object relative to the living body using therelative position of the at least one first locator component to the atleast one second locator component.

In some embodiments, the object is an implantable device and the atleast one first locator component is positioned proximate an engagementpoint of the implantable device within the living body. In someembodiments, the computer system is further configured to periodicallymeasure the relative location of the object to the living body using oneor more outputs subsequent to placing the implantable device within theliving body. In some embodiments, the object is a surgical instrument.

In some embodiments, the object is affixed to a robotic mechanismoperably coupled to the computer system and the computer system isfurther configured to control the robotic mechanism according the one ormore outputs.

In some embodiments, the first locator component includes a plurality offirst locator components and the second locator component includes aplurality of second locator components. The computer system may beconfigured to measure the orientation of the object relative to aportion of the living body engaging the second locator components basedon the one or more outputs.

In some embodiments, the at least one locator component has enhanceddetectability with respect to a non-visual imaging modality, such as atleast two non-visual imaging modalities.

In some embodiments, the at least one first locator component is withinthe living body. In some embodiments, the at least one first locatorcomponent is further configured to detect at least one parameter of theliving body.

In some embodiments, the plurality of static components are affixedwithin a man-made confined space.

In some embodiments, an LPS system includes a plurality of staticcomponents affixed relative to one another about a living body and atleast one first locator component positioned affixed to the living bodyand operable to receive signals from the plurality of static components.The system further includes at least one second locator componentaffixed to an object, the plurality of static components and at leastone first component operable to communicate effective to establishlocations of the at least one first locator component and at least onesecond locator component. The computer system may be in datacommunication with the at least one first locator component and the atleast one second locator component and configured to detect one or moreoutputs of at least one of the plurality of static components, the atleast one first locator component, and the at least one second locatorcomponent. The computer system may further be configured to measure aposition of the second locator components relative to the first locatorcomponents according to the one or more outputs.

In another embodiment the methods for localization described above canbe applied to an organ or structures other than the parathyroid orthyroid and can include but is not restricted to the musculoskeletalsystem to include but not restricted to ACL graft placement, hardwaresurgical placement and kidney, heart and neuro-endocrine tumorsdiagnosis and treatment.

In another embodiment the methods for image correction can be applied toan organ other than the parathyroid and can be used for diagnosis,treatment or a combination of diagnosis and treatment and include but isnot restricted to the parathyroid, thyroid, other endocrine organs, themusculo-skeletal system, the reproductive systems, the kidney, heart andneuro-endocrine organs or tumors.

Another embodiment can include but is not restricted to a sensing deviceor method for parathyroid identification to include but not restrictedto thermography, heat sensitivity and near infra-red, infra-reddetection or imaging or a combination of imaging and detection wherethese methods can be used to identify and diagnose the location of theabnormal parathyroid gland which is more vascular and exudes more heatthan other less vascular thyroid and other local tissue. This can beused for diagnosis or treatment or a combination of diagnosis andtreatment to include but not restricted to the use of near infra-red,infrared other electromagnetic wavelength analysis.

Another embodiment can include but is not restricted to a heat sensingparathyroid identification method where the thyroid tissue is suppressedand the vascularity reduced which reduces the heat generated by thethyroid and provides greater conspicuity between the parathyroid and thethyroid and allows the parathyroid to be more easily detected. Onemethod for reducing thyroid activity can include but is not restrictedto propylthiouracil and methimazole (Tapazole) and thiourea andthiouracil and their derivatives.

Another embodiment can include but is not restricted to a heat sensingparathyroid identification method where the parathyroid gland ishyper-stimulated using methods to include but not restricted to theadministration of thiazide derivatives such as hydrochlorothiazide, orinorganic phosphates. The stimulation of the abnormal parathyroidincreases the heat production and blood flow of the parathyroid glandthyroid and provides greater conspicuity between the parathyroid and thethyroid and allows the parathyroid to be more easily detected.

One embodiment can include but is not restricted to a method where thestandard Tc-99 Sestimibi is used in conjunction with a method where thethyroid tissue is suppressed and the vascularity reduced which reducesthe radioactive uptake by the thyroid. This can provide greaterconspicuity between the parathyroid and the thyroid and allows theabnormal parathyroid gland to be more easily detected. One method forreducing thyroid activity can include but is not restricted to elementaliodine and potassium iodine administration to include but not restrictedto lugol solution doses in the range of approximately 15 mg/day forinfants, 65 mg/day for children and 130 mg/day for adults,propylthiouracil and methimazole (Tapazole) and thiourea and thiouraciland their derivatives and perchlorate, pertechnetate and thiocyanate.This can be given prior to the Tc-99 Sestimibi injection and imaging.This represents a new use for these thyroid suppression medications.

Another embodiment can include but is not restricted to a method wherethe standard Tc-99 Sestimibi is used for detection and localization ofthe abnormal parathyroid gland in conjunction with a method where theparathyroid gland is hyper-stimulated. The stimulation of the abnormalparathyroid increases the uptake and radioactivity of the parathyroidgland and provides greater conspicuity between the parathyroid and thethyroid and allows the abnormal parathyroid gland to be more easilydetected. One method for hyper-stimulating the parathyroid gland caninclude bit is not restricted to the administration of thiazidederivatives such as hydrochlorothiazide, or inorganic phosphates.Methods to alter uptake by the parathyroid can also include but are notrestricted to administration of medications prior to the Sestamibi examto include but not restricted to calcium and calcium derivatives such ascalcium carbonate.

One embodiment can include a method where the electromagnetic lightspectrum is used to localize an organ to include but not restricted to aparathyroid adenoma. A parathyroid adenoma because of its uniquecellular make-up and its blood supply is orange. Using a method where aspecific wavelength in the electromagnetic spectrum is assigned to theparathyroid to include but not restricted to a central rangeapproximating 590 to 625 nm the reflection, translucence, transducingcapacity or the absorption of this wavelength can be used to detect andlocalize a parathyroid adenoma. Depending on the size and vascularity ofthe parathyroid adenoma the specific wavelength may vary from thisrange. The method can be used to distinguish the parathyroid tissue fromthe adjacent supportive tissue and the thyroid, which have a reflection,translucence, transducing capacity or the absorption of this wavelengthdifferent from the parathyroid adenoma. Other specific electromagneticwavelengths can be used to identify other organs or body tissues. Thismethod can include but is not restricted to incorporatingphotospectroscopy and PAI and optical and endoscoptic methods.

In another embodiment the methods and uses and devices described in thisembodiment can be used on living creatures to include but not restrictedto humans.

In another embodiment frames or frame—like devices can be used to butare not excluded to being used to fix in place the radioactive sources,the positioning devices, surgery and surgical assistance devices, and tofix a structure in a fixed or relatively fixed mechanical position.

The application of these methods and embodiments can include but is notrestricted to integrating these methods and processes and embodimentswith or into a Computer Assisted/Aided Device (CAD) or platform orprogram.

The same methods for acquiring data for target localization can includebut are not restricted to parathyroid, thyroid and other body parts canuse but are not restricted to radioactivity.

The localization methods can be used to assist treatment of parathyroidgland dysfunction. Surgical. Percutaneous, Tightly Targeted minimallyinvasive, and non-invasive and non-surgical approaches to parathyroidtreatment can benefit from precise localization of the abnormalparathyroid gland and localization techniques described in this patentcan be combined with surgical and invasive, minimally invasive andnon-invasive treatment techniques to include for both localization andtreatment techniques to include but not restricted to energy that caninclude but is not restricted to Radiofrequency ablation (RF) andmicrowave (MW) and laser (L), Ultrafast Laser (UL), Cryotherapy (CryT),High Intensity Focused Ultrasound (HIFU), Radioactive Therapy(Brachytherapy: BrT), Irreversible, Electroporation (IRE), ElectricalCurrent Therapies, Electrocautery, Magnetic Resonance (MR), Ultrasound,(US), Cautery and kinetic or mechanical energy, Thermal energies bothheat and cold and mechanical or kinetic energies and with adjuvantcombinations that can include but are not restricted to medicationdelivery, Medication packets, blood flow reduction, Chemical andMedication Ablation, Activation and Deactivation and Modulation Therapy,Adhesives and Glues and Molecular Crystal and Lattice therapies, TargetTissue Delivery Device Therapies, Peptide and Biological ConversionTherapies, MR and RF and Magnetic External Heating Therapies,Hyperthermia with Adjuvant Therapy, Hypothermia with Adjuvant Therapy,Local protective therapy in the Vicinity of the Target Organ Therapy,Suction and Expansion Therapy, Positive Pressure and Expansion Therapy,Mechanical Ablation Therapy and Combinations of therapies. Oneembodiment can include but is not restricted to a percutaneous placementmethod of a device can be guided using imaging or LPS systems oflocators and the device can be placed adjacent to the parathyroid and anenergy activating substance such as but not restricted to a photo oracoustic sensitive substance can be inserted into or around theparathyroid or a parathyroid blood vessel and then the activating energycan be initiated which can result in but not restricted to ablating allor a portion of the parathyroid and the energy or activating substancecan be created to have variable amounts of ablating or stimulating ortreatment capacities which are dependent on but not restricted to theenergy intensity or wavelength or periodicity or pulsatility, which isserve as a control of the treatment and also control the exposure of thelocal environment to that treatment to minimize undesired side-effectsof the treatment.

In another method the ultrasound transducer is combined and/orincorporated with a positioning or locator device such that theultrasound transducer position can be identified and recorded within thecoordinates of the GPS or LPS coordinate system.

In some embodiments, a method for measurement includes providing anobject having one or more first markers affixed thereto and affixing oneor more second markers to a living body. The one or more first markersand one or more second markers are then detected, by a computer systemusing a non-visual imaging modality. The computer system may measure arelative location of the object to the living body using the one or morefirst markers and one or more second markers. For example, in someembodiments, the method may include controlling positioning of theobject relative to the living body using the relative location.

In some embodiments, the object is a prosthesis and the one or moresecond markers are positioned proximate an engagement point of theprosthesis with the living body. The prosthesis may be configured toconform to the engagement point. In some embodiments, the method maymonitoring a position of the prosthesis relative to the engagement pointsubsequent to embedding of the prosthesis in the living body.

In other embodiments, the object is a surgical instrument. The objectmay be affixed to a robotic mechanism and the computer system may beconfigured to actuate the robotic mechanism according to the relativelocations of the one or more first markers and the one or more secondmarkers.

In some embodiments the one or more first markers and one or more secondmarkers include GPS receivers or LPS receivers, such as the GPS and LPSreceivers described herein. The GPS or LPS receivers may transmit datato the computer system to enable the computer system to determine thelocations of the GPS or LPS receivers.

In some embodiments, the one or more first and second markers haveenhanced detectability with respect to the non-visual imaging modality.The one or more first and second markers may have enhanced detectabilitywith respect to the non-visual imaging modality and at least one othernon-visual imaging modality.

In some embodiments, the one or more first markers include a pluralityof first markers. The plurality of first markers may be secured to asurface of the living body or implanted in the living body. The computersystem may be configured to measure an orientation of the objectrelative to a reference direction established by the plurality of secondmarkers. In some embodiments, the one or more second markers include aplurality of second markers. The computer system may be configured todetermine the reference direction according to the plurality of firstmarkers and determine the orientation of the object, e.g. relative tothe reference direction, according to the plurality of second markers.

In some embodiments, at least one of the one or more second markersincludes at least one sensor configured to detect at least one parameterof the living body. The one or more second markers may further includetransmitters for transmitting data representing the at least oneparameter.

In some embodiments, the object is a portion of an imaging device. Theportion of the imaging device may be configured to be insertable withinthe living body.

In some embodiments, an imaging system is operably coupled to thecomputer system. The computer system may be programmed to detectlocations of the first and second markers in an output of the. As notedabove, the first and second markers may have enhanced detectability inone or more non-visual imaging modalities, such as any of the imagingmodalities described herein.

Elastomeric Gel MRI Markers:

The use of skin markers is important in Magnetic Resonance Imaging(MRI). Skin markers have two primary functions. First markers can beplaced at the site of a patient's pathology. This provides a method bywhich the radiologist and technician can reliably identify and scan thearea being evaluated. The second use of skin markers is to provide areference point to enable the technician and radiologist to number thevertebral bodies. This is particularly important in the thoracic spineregion where distinctive bone landmarks are often absent or lessreliable than in the lumbar or cervical regions.

Criteria for an optimal marker should include (1) reliable visualizationon all appropriate sequences, (2) minimal to no artifacts, (3) a varietyof sizes and shapes appropriate for the multiple anatomic sites beinginvestigated and the various applications being performed (4) minimal tono distortion of the local anatomy, (5) ability to conform to thecontours of the local anatomy, (6) easy to use and adhere to skin, (7)biologically safe and non-toxic with MM use, (8) preferably not a liquidwhich can spill (9) inexpensive to produce, and (10) a shape that can beproduced that is not confused with anatomic shaped structures and (10)in some embodiments can be used with multiple imaging modalities toinclude but not restricted to MR, CT and Ultrasound.

The most common markers in use today include peanuts, soy saucepackages, and fish capsules. Other markers that have been described inthe literature but which are not in daily routine usage are Lipiodolmarkers, Gadolinium-DTPA filled tubes, non-magnetic wires inserted intothe skin for breast biopsy and discs of an un-hydrated co-polymer ofvinyl pyrrolidone and phenyl methacrylate subsequently hydrated in asolution of copper sulfate. Each of the above has one or moresignificant limitations.

Many of the above are seen well on some but not on other sequences.Markers such as fish oil capsules and gadolinium filled tubes thatcontain predominantly fat or T1 shortening materials are easily detectedon T1 weighted sequences but are poorly visualized or not seen at all onT2 weighted sequences. For markers that contain primarily water-basedmaterials the reverse is true. They are seen well on T2 weightedsequences but are poorly or not seen on T1 weighted sequences.

Additional limitations occur with the various markers because they haveto be packed in firm or hard or poorly or non-conforming coatings orcapsules and these can confuse the interpretation between distortedanatomy and pathology. Fish oil capsules and peanuts distort the localanatomy in superficial masses. Soy sauce packages, which containabundant amounts of water may generate artifacts on T2 weightedsequences. Also, soy sauce packages and fish oil capsules can and doleak.

Other limitations include the inability to use the same or a similarmarker for different imaging modalities. For example MR markers such asfish oil capsules can be difficult to see with CT and Ferro magnetic orstrongly paramagnetic substances or metals and wires placed onto theskin for CT are not practical for routine non-invasive MRI usage.Additional limitations of current markers include but are not restrictedto unreliable visualization of the marker on all appropriate sequences,many and variable artifacts, limitations in sizes and shapes appropriatefor the multiple anatomic sites and the various application beinginvestigated, distortion of the local anatomy, inability to conform tothe contours of the local anatomy, and shapes that are confused withanatomic and biological structures, biologically unsafe and toxic andusefulness with only one imaging modality and not able to be seen orused with multiple imaging modalities.

In some embodiments, an elastomeric gel Mill marker utilizes a blockcopolymer with plasticizing oils. Although these gels can bemanufactured with many possible combinations of polymers depending onthe T1 and T2 weighted imaging characteristics desired, the currentembodiment employs a triblock copolymer composed of 25 to 50%(plasticizing oils). In the current embodiment the gel can include butis not restricted to be encapsulated fully or partially with a membraneor coating that can include but is not restricted to a firm or flexibleor plastic or wax covering. The gel markers can be produced with nomembrane or the gel marker can have no coating or membrane.

In some embodiments, a marker for imaging applications includes aflexible structure conformable to a part of a living body, the flexiblestructure formed of a gelatinous elastomer. The flexible structurefurther includes one or more materials effective to provide enhanceddetectability in a plurality of imaging modalities in addition to thehuman visible spectrum. In some embodiments, at least one surface of theflexible structure at least one of is tackified and has an adhesivematerial secured thereto.

In some embodiments, the flexible structure is secured to a rigid frame,the frame having at least one surface configured to conform to a portionof the living body. In other embodiments, the flexible structure issecured to a wearable item configured to fit over a portion of theliving body. In some embodiments, the flexible structure secures to aportion of a hook-and-loop fastening system.

The one or more materials of the marker may each have a signature in theplurality of imaging modalities that is distinguishable from tissueadjacent the flexible structure in the living body. The plurality ofimaging modalities may include at least two of ultrasound, x-rays,computer tomography, magnetic resonance imaging, and nuclear medicineimaging. In some embodiments, the plurality of imaging modalitiesinclude at least two magnetic resonance imaging sequences selected from:T-1 spin echo, T-2 spin echo, gradient echo, turbo spin echo,spectroscopy and inversion recovery, fluid attenuated inversionrecovery, and short T-1 inversion recovery.

The one or more materials may be substantially homogenously mixed withone another and may be homogeneously mixed with the gelatinouselastomer. In some embodiments, the flexible structure defines a cavityand at least one of the one or more materials is positioned within thecavity. In some embodiments, an electronic device is positioned withinthe cavity. The electronic device may include at least one sensoroperable to detect at least one of an environmental factor and abiological process of the living body, and a transmitter coupled to thesensor and operable to transmit a representation of at least one outputof the at least one sensor. The marker may include a radiation exposuresensor.

In some embodiments, the flexible structure has a non-natural perimetershape. For example, the non-natural perimeter shape may be at least oneof a circle, triangle, square, and ellipse. In some embodiments, theflexible structure defines an annular shape having a void providingaccessibility to skin of the living body to which the marker is secured.In some embodiments, the gelatinous elastomer is resiliently deformable.

In another embodiment, a marker for imaging applications includes aflexible structure conformable to a part of a living body. The flexiblestructure may incorporate first and second materials. The first materialmay be at least one of a hydrophilic and a water-like material at leastone of a lipophilic material, lipid, oil, and fat-like material. Thesecond material may be at least one of a hydrophilic and a water-likematerial. The first and second materials may be mixed together, such ashomogeneously mixed. In some embodiments, the flexible structureincludes a gelatinous elastomer, such as a resiliently deformablegelatinous elastomer. The gelatinous elastomer may incorporate the firstmaterial and second material in a block copolymer. In some embodiments,the first material has a T-1 weighted sequence result having anintensity at least as great as fat of the living body and the secondmaterial has a T-2 weighted sequence result at least 25% as great asthat of cerebrospinal fluid of the living body. In some embodiments, thesecond material has a T-2 weighted sequence result that is one of 10% asgreat, 25% as great, 50% as great, 75% as great, 90% as great, and 100percent of that of cerebrospinal fluid of the living body. But dependingon the local tissue environment the T1 marker difference from the T2 orthe T2 marker difference from the T1 environment can be reduced to lessthan 10 percent or greater than 100 percent of absolute values.

In some embodiments, the marker has enhanced detectability in an imagingmodality other than the human visible spectrum, the imaging modalityincluding at least one of ultrasound, x-rays, computer tomography, andnuclear medicine imaging.

A method for diagnosing a condition may include applying one or moremarkers to a living body, each of the one or more markers having adifferent marker signature in a first imaging modality. The method mayfurther include generating an image of at least a portion of the livingbody including the one or more markers using the first imaging modalityand comparing a tissue signature of a representation of tissue in theliving body in the image to the marker signatures of a representation ofthe one or more markers in the image. A condition of the tissue may thenbe diagnosed according to the comparison. The steps of comparing anddiagnosing may be performed by a computer system. In some embodiments,the one or more markers may include a plurality of markers each having adifferent combination of T-1 weighted compounds and T-2 weightedcompounds.

Diagnosing the condition of the tissue according to the comparison mayinclude determining at least one of bone marrow composition, extent offatty liver condition, extent of fibrotic liver condition, extent ofosteoporosis, presence of diabetes, degree of pancreatic fattyreplacement, presence of adenomas, presence of tumors, presence ofaggressive tumors, body fat calculations, and presence of metabolicreplacement diseases.

Still other embodiments of the present invention will become readilyapparent to those skilled in the art from the following detaileddescription, wherein is described embodiments of the invention by way ofillustrating the best mode contemplated for carrying out the invention.As will be realized, the invention is capable of other and differentembodiments and its several details are capable of modifications invarious obvious respects, all without departing from the spirit and thescope of the present invention. Accordingly, the drawings and detaileddescription are to be regarded as illustrative in nature and not asrestrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 depicts the anatomic relationship of the four parathyroid glandsin their general relationship to the thyroid.

FIG. 2 depicts the four parathyroid glands and thyroid in relationshipto other organs that take up radioactive Sestamibi in the body and canbe used to realign and to improve parathyroid imaging through temporalmapping and realignment, such as by using external markers can be usedto assist alignment.

FIG. 3A depicts an example of alignment and non-alignment in FIG. 3B andthen realignment FIG. 3C. By using the mechanical or mathematicalmodeling program 24, the misalignment in FIG. 3B which can be caused bya change in position from the initial position FIG. 3A can be correctedby mechanical or mathematical modeling to return to a similar positionFIG. 3C as was present in the initial position FIG. 3A.

FIG. 3C is enhanced data after the alignment and/or modeling and/orenhancement programs have been applied.

FIG. 4 A depicts an external locating device or locator that can includebut is not restricted to a Global Satellite Positioning Device (GPS) ora Local Positioning Device (LPS) that can be used to assess thecoordinates of the target organ, the parathyroid and thyroid or otherbody parts with an associated locator on the target organ.

FIG. 4 B depicts a coordinate system generated from the LPS or GPS orradioactive or CAD system that can be used to triangulate and locateregions of an anatomic structure.

FIG. 5 depicts a sensor, detection or diagnostic or treatment assistancedevice that can be used in conjunction with or separate from otherlocalizing devices or localizing methods. Sensors can be external orinternal in nature as related to the body. The sensor can be put intoposition with methods that can include but are not restricted to beingswallowed, inhaled, injected, placed onto, or put into or through theskin or mucosa or an orifice. In this depiction the sensor is a thermalsensor that can be positioned both in the skin and also in the esophagusto assist with the triangulation of the position of the abnormalparathyroid gland. The target organ can be interrogated before or afteror while being excited by an energy method or source.

FIG. 6 depicts an example of a frame or fixation device and method thatcan be used to maintain or fix a location device or sensor relative tothe body part or the target organ or structure or body.

FIG. 7 is an ultrasound transducer, which incorporates a positioning orlocation/locator device that can transmit and receive signals that canbe identified and recorded within the coordinates of the GPS or LPS orother coordinate system.

FIG. 8 is a prosthesis or medical hardware or implants or device thatcan incorporate one or more positioning or locator devices that cantransmit and receive signals that can be identified and recorded andcoordinated with the coordinates of the GPS or LPS coordinate system.

FIG. 9 is a prosthesis or medical hardware or implants or device thatcan incorporate one or more positioning or locator devices that cantransmit and receive signals that can be identified and recorded andcoordinated with the coordinates of the GPS or LPS 16 coordinate systemand is viewed in relationship to a body part in this case a knee 19.

FIG. 10 is an elastomeric gel marker of variable thicknesses and shapesincluding an annular marker with an area that can serve as a conduitthrough which a needle or object can be passed.

FIG. 11 is a gel markers that can include but are not restricted toinclude a reservoir for radioactivity, or have a sensor deviceintegrated into the gel and can include adhesives and fasteningsubstances or a frame (not depicted) and can be used with and serve asmarkers for other imaging methods such as MRI and CT and ultrasound.

FIG. 12 is a depiction of a series of arterial waveform changes in ornear a tissue bed which in this depiction is the corpora cavernosum ofthe penis.

DETAILED DESCRIPTION

FIG. 1 depicts the anatomic relationship of the four parathyroid 4glands in their general relationship to the thyroid 2. Most people havefour parathyroid 4 glands (some have fewer than four and some have morethan four parathyroid 4 glands). These parathyroid 4 glands lie (behind)the Thyroid 2 gland in the lower neck. They are separate from yourthyroid 2 gland. The parathyroid 4 gland controls Calcium levels in thebones and blood. Despite this general description of the parathyroid 4glands location 66 in reality Parathyroid 4 glands are variable inlocation 66 and can reside as craniad as the submandibular glands and ascaudad as the lower mediastinum. Although most individuals have oneabnormal parathyroid 4 gland some individuals can have two or moreabnormal parathyroid 4 glands. The accurate pre-surgical andintra-operative identification of the location 66 of the normal andabnormal parathyroid 4 glands is paramount to successful treatment ofhypercalcemia and hyperparathyroidim with the fewest complications.

FIG. 2 depicts the four parathyroid 4 glands and thyroid 2 inrelationship to other organs of the body that take up radioactivity inthe body, such as sestamibi or some other radioisotope or othersubstance for enhancing detectability of an organ in a non-visualimaging modality. The organs and can be used to realign and to improveparathyroid 4 imaging through temporal mapping and realignment. In theregion of the head and neck the salivary glands 5 and the nasal and oraland nasal mucosa 6 take up activity and retain radioactivity. In thetorso, other body parts that can be used as references to realign theimages include the heart 37, liver 38 and spleen 39. Both the outlinepoints and one, or more than one, points including an internal or centerpoints can be used to determine location 66 of the body organ part whenused in the realignment protocol. Radioactive external source markers 8,sensors 20, locators 12, or the like, can be used to assist alignment.

FIGS. 3A-3C depicts one embodiment method for alignment 1 and modeling24. FIG. 3A illustrates a temporal point and corresponding image anddata. FIG. 3B illustrates a later temporal point and corresponding imageand data. FIG. 3C is the post processing realignment 1 image thatcorrects temporal point B's image such that it is returned to thealignment 1 of temporal point A's image and data. By using modeling 24methods to include but not restricted to mechanical or mathematical dataand image correction modeling programs 24, the realignment 1 in positionof FIG. 3B/temporal point B can be performed by modeling correctionprograms 24 to return FIG. 3B to a similar position/image and data pointpositions, which can include and are not restricted to voxels andpixels, and is now referred to as FIG. 3C which is now in the initialposition of FIG. 3A. After this correction has occurred then oneembodiment can include but is not restricted to supplement the new dataset with additional modeling 24 that can include but is not restrictedto enhancing, reducing, and/or filtering the data points as exemplifiedin FIG. 3C. In one embodiment the liver 38 and spleen 39 and salivaryglands 5 and heart 37 can be used as internal markers of alignment, anexternal 8 marker 32 can be affixed to the body. A mathematical modelcan be used to assess the movement 22 or the rotation 22 of each ofthese organs or markers 32. Mathematical modeling 24 can utilize but isnot restricted to edge detection, step detection, edge thinning, using aKirsch operator, pixel or voxel realignment 1 which can include but isnot restricted to measuring the number of pixels or voxels or both andcomparing the increase or decrease in the number of pixels or voxels inany direction and correcting the movement to align or change in positionto or with the original or propositus image. This process can beperformed once or more than once to fine-tune or adjust the statictarget locations.

FIGS. 4A and 4B depict an example of an external locating device 8 orlocator 12 that can include but is not restricted to a Global SatellitePositioning Device (GPS) 14 or a Local Positioning Device (LPS) 16 thatcan be used to assess the coordinates of the target body organ which insome embodiments includes but not restricted to the parathyroid 4 andthyroid 2 but can include other body parts (not depicted) to include butnot restricted to joints such as a knee 19, hip 18, shoulder, or bodyorgans, such as the heart 37, liver 38 or spleen 39 that can use, butare not restricted to use, an internal or external locator 8 or locatordevice 12 to assist in localization of the target organ which in thisdepiction is the parathyroid 4. The GPS 14 system can use standard GPSmethods which can be modified to smaller targets. In the LPS 16 method aspace can be created which contains transmitters 50 and receiver 51devices 12 referred to as location devices 12 or locators 12. Theselocator 12 devices can be positioned strategically within the said spacesuch that their distance is assessed and by combining these locators 12a grid or coordinate 30 system or map can be generated which can be 2-Dor 3-D and in which all points within the grid or coordinate system 30can be defined or calculated. In the some embodiment there will be fixedlocators 12 that create the coordinate system and there will benon-fixed or mobile locators 12 which when positioned in the coordinatesystem the non-fixed locators can be found or located or defined aposition in the grid or map or coordinate system 30. FIG. 4B depicts thecoordinates can be generated in two planes if the coordinates are 3-D toinclude plane one and a plane perpendicular to plane one. The non-fixedlocator is like a cell phone containing GPS 14 which is located in thelarger satellite generated world GPS 14 system. The GPS 14 system isuseful for objects that are macro in size with resolutions of about a 12inches/30 cm but not used for objects in the 0.1 inch/3 mm range. Theadvantage of the LPS 16 system is that it can more precisely resolve theposition of an object in a map or grid or coordinate system 30 in the0.1 inch or 3 mm or less range which is what is needed for medicalapplications.

In some embodiments, an actual LPS system may be built into a room andthe LPS system defines a 2-D or 3-D grid system and enablesvisualization of objects smaller than permitted by GPS may be isolatedfrom the GPS system and the environment. In one embodiment an LPSlocator system can be limited to a space smaller than a room and thatspace can be but is not restricted to being portable such as but notrestricted to a helmet that is placed over the patient's head andlocators with the capacity to send and receive can be distributed aboutthe helmet. In addition, the helmet can be composed of a material toinclude but not restricted to copper, which in some embodiments isexternal to the transmitters and receivers relative to the patient. Inthis embodiment the helmet serves as a Faraday Cage with the locators,transmitters and receivers internal to the Faraday cage with thelocators, transmitters and receiver between the Faraday Cage and thepatient. A method for signal transfer of information from the locators,transmitters and receivers to the environment, outside of the Faradaycage, can be created by insulating the external portals with sufficientRF insulation.

In one application, a superficial address or location on the body may bedetermined using the LPS system. This can be used in a manner to find aspot on the body to include but not restricted to find a location on thebody to plan a surgery, perform a biopsy, use for treatment such asfinding abnormal anatomy and treating that anatomy with methods toinclude but not restricted to laser light markers to mark anatomy forthe biopsy or for the surgical site. The best application may be placinga locator into an Ultrasound transducer and then interrogating theanatomy from that point so that the secondary imaging system is alignedwith the part of the body to be interrogated.

In some embodiments, the LPS system can be used to treat a patient withradiation such as gamma knife or external beam radiation especially forsuperficial lesions. Unlike current methods it does not rely on anancillary imaging but can be used with ancillary imaging if needed.

In another application, a superficial address or location on the bodymay be coordinated with an imaging systems, such as a non-visual imagingmodality which can include but is not restricted to CT, MR, PET, otherNuclear Medicine, ultrasound or thermography. The locators can be placedonto the patient and an imaging system used to identify the internalanatomy relative to the superficial anatomy. The imaging data and theLPS locators may be used to guide a transducer or other imaging and/orexternal locators.

In another application, an LPS locator system is in place and one ormore than one external LPS locators can be affixed to the patient andone, or more than one locators, may be placed internally within thebody. This method can be used with additional imaging systems to includebut not restricted to CT, MR, PET, other Nuclear Medicine Ultrasound orthermography. One or more than one locator devices can be usedinternally and within the patient's body. The locator can be placed onor within a structure to include but not restricted to a prosthesis orimplants or can be integrated into a surgical probe or scalpel or ameasuring device including devices that measure distances or angles. Thelocators can be used to guide procedures in the body such asintubations, endoscopies, Nasogastric tube placement, cathetersincluding but not restricted to vascular or hollow viscouscatheterizations. In another embodiment, the locators within the bodycan be used to outline a tumor or infection to measure the increase ordecrease in size or location of the tumor or infection.

In some applications, the locators can be placed such that the locationof an implanted device that can include but is not restricted to aprosthesis or a device in which the precise location of the implanteddevice or structure relative to the body part is important or critical.

In some embodiments, a prosthesis such as a knee prosthesis can havelocators incorporated into the prosthesis and the adjacent bone can havelocators. The position of the prosthesis relative to the bone can bemeasured precisely This is specifically important since loosening of theprosthesis relative to the bone is difficult to image because theprosthesis is composed of metal which generates significant artifactswith CT and MR and US and MR. This technique will allow real-timeanalysis of the prosthesis tightness or loosening by measuring thedistance between the prosthesis and the bone when it is implanted andthen after the surgery when the implant needs to be analyzed forlocation, mechanics and loosening. Loosening is important because it canbe associated with infection, damage to the cement or the bone orprosthesis, or it can be associated with a gap or movement of theprosthesis relative to the bone.

In some embodiments, a sensor can be positioned or integrated into aprosthesis or a graft. This can be used with a locator or combinationincluding the locator. The sensor can have a transmitter and a receiverthat can send and receive information as related to the object implantedinto the body. In some embodiments an ACL graft can have sensors thatcan obtain measurements to include but not restricted to tensilestrength, blood flow, infection, inflammatory cells, chemical propertiesto include but are not restricted to biological properties including butnot restricted to temperature, tensile strength, translucence orchemical signatures that can include but are not restricted to lacticacid, glucose, pH, sodium potassium, protein and peptides, fatty acidsand carbohydrates. This information can be obtained by acquiringinformation from or delivering a substance to the structure beinginterrogated and can include but is not restricted to an energy or asolid or liquid or gas. In one embodiment the information can pertain tobut is not restricted to the tensile strength or stretch of the graft,which can include measuring the distance between two locators or sensorsat rest and with a stretching force placed upon the graft. Or thesensors can measure pH, oxygen, nitrogen, CO2, or glucose or anycombination of these or other biological or non-biological parameters,which can change or vary in the tissue or the environment surroundingthe tissue of the graft, which can vary when exposed to a damaging thesituation that can include but is not restricted to an infection orbreakdown of the graft which may vary one or more than one of the sensedparameters when compared to the steady state or previously measured ornormal parameters of the graft to include but not restricted to one ormore of pH, oxygen, nitrogen, CO2, or glucose or any combination ofthese or other biological or non-biological parameters as may occur butis not restricted to an infection with an aerobic or an anaerobicorganism. In another embodiment, the sensor can deliver can have but isnot restricted to a ceramic or semiconductor sensing chip that canmeasure or detect flow and can be used to determine the presence orabsence of blood flow in the graph. The graft can be exposed to anexternal energy or substance to include but not restricted to heat orlight or ultrasound and the sensory device can measure parametersrelated to these sensory inputs. Another embodiment can include but isnot restricted to an endocrine or exocrine organ that can include but isnot restricted to insulin from the pancreas, parathyroid hormone fromthe parathyroid, gastrin from the stomach, thyroid stimulating hormone(TSH) from the pituitary, thyroid releasing hormone (TRH) from the andthyroid hormone from the thyroid. The sensory device can transmit orreceive information. Other biological tissues of the body including butnot restricted to a joint graft can be interrogated by this sensingdevice and can include but are not restricted to joints, eye, kidney,skin, heart and other normal and abnormal body organ and can include butis not restricted to abnormal tissue to include tumors and tumorreleasing hormones or peptides or metabolic normal occurring or abnormaloccurring biological or non-biological by-products or biologicals ofmetabolism.

FIG. 5 depicts a sensor, detection or diagnostic or treatment assistancedevice 20 that can be used in conjunction with or separate from otherlocalizing devices or methods using localizing devices. Sensors 20 canbe external or internal in nature as related to the body. The sensor 20can be put into position with methods that can include but are notrestricted to being swallowed, inhaled, injected, placed onto, or putinto or through the skin 60 or mucosa 6 or an orifice of the body. Inthis application, skin 60 and mucosa 6 may be used interchangeably sincethey are both coverings of the body or body parts. In FIG. 5 the sensor20 is a depiction of a thermal sensor that can be positioned both in oron the skin 60 and also on the mucosa 6 of the trachea (not depicted) orthe esophagus 61 and the sensor 20 may measure a sensory output of theparathyroid 4 and or the thyroid 2, but can be used with other bodyparts and may utilize data 42 to include but is not restricted toelectromagnetic, kinetic or mechanical signals or outputs that caninclude but are not restricted to heat, electromagnetic wavelengths,vibrations, sound, secretions, excretions, change in position to includebut not restricted to flow or movements to include but not restricted toblood and urine flow, intrinsic and extrinsic solid or liquid or gel orgas within or about or associated with body organs. Such sensor 20embodiments can include but is not restricted to a sensing device ormethod for parathyroid 4 identification to include but not restricted tothermography, heat sensitivity and near infra-red, infra-red detectionor imaging or a combination of imaging and detection where these methodscan be used to identify and diagnose the location 66 of the abnormalparathyroid 4 gland which is more vascular and exudes more heat thanother less vascular thyroid 2 and other body local tissue. This can beused for diagnosis or treatment or a combination of diagnosis andtreatment to include but not restricted to the use of near infra-red,infrared other electromagnetic wavelength analysis. The sensor 20 can becombined with, or integrated with, a locator 12 and used to assist withthe localization and also the characterization of the position of theabnormal parathyroid gland 4 in the coordinate system 30 when equippedwith a locator 12. A sensor 20, locator 12, or marker 32 can include aradiation exposure sensor. A sensor 20, locator 12, or marker 32 maysense or emit radiation. These methods can assist with bothtriangulation or the positioning of the abnormal parathyroid gland 4 andcan also assist with determining function and characterization of theparathyroid 4 and its local functional environment. Thus simultaneouslyproviding a location 66 and a physiologic 67 status for a body partwhich in some embodiments is the parathyroid 4 and thyroid but can beapplied to other local and more distal body structures such as bodyparts to include but not restricted to nerves, vessels, organs andcoverings.

FIG. 6 depicts an example of a frame 10 or fixation device 10 and methodthat can be used to maintain or fix the frame 10 and a location device12 and/or sensor 20 relative to the body part or the target organ orstructure or body. The method may include affixing the frame 10 to aliving body. One or more location devices 12 and/or one or more sensors20 affixed to the frame may then be detected according to any of themethods disclosed herein to determine a position and/or orientation of aportion of the body engaging the frame. The location devices 12 andsensors 20 can be embodied as any of the markers, locators, locatingdevices, or sensors, disclosed herein.

FIGS. 1 through 6 illustrate methods for identifying and localizing andsensing bodily structures which can be used, but are not restricted touse, in processing nuclear medicine images and radioactivity informationacquired and compared over one or more time intervals in order tocompare separate images and radioactivity using one or more isotopes.This method uses identified target organs to align 1 body structures andassess their two or three dimensional location 66 based on acquired data42, such as based on a two dimensional projection with a modified ormodulated or subtracted Nuclear medicine image. Specifically thistechnique can be useful and be applied to, but not restricted to,parathyroid gland 4 detection imaging.

The normal thyroid 2 activity decreases its activity over time. Theabnormal parathyroid 4 activity increases its activity over time. Earlyimaging of the parathyroid 4 is masked by higher radioactivity countrates in the thyroid 2. Over time the thyroid 2 activity theoreticallydecreases to a level low enough that the parathyroid 4 activity willbecome greater than the thyroid 2 activity. Although this event occursin this manner in many patients, this phenomenon does not occur in asignificant number of patients. In about 30 to 50% of patients thethyroid 2 and the parathyroid 4 activity can be overlapping or thethyroid 2 radioactivity does not reduce sufficiently to yield aconfident diagnosis for a parathyroid 4 adenoma.

In order to increase the confidence of the abnormal parathyroid 4diagnosis and improve the conspicuity between the thyroid 2 activity andthe parathyroid 4 activity, imaging methods can be applied to overcomethe limitations of persistent thyroid 2 activity.

One method uses Tc-99 Sestamibi as the diagnostic isotope for generatingradioactivity. A nuclear medicine camera device assigns regions ofinterest (ROI) or pixels to the body. This information is collected atdifferent points in time (a temporal data 42 set or temporal map). Thesedata 42 sets can be compared. A Region of Interest (ROI) is assigned avalue and depending on the increase or decrease in that ROI the pixelcan include but not restricted to be amplified, remain the same,diminished or modulated by a mathematical model in relationship to butnot restricted to the present, future or the past images or the adjacentpixels or data 42 sets.

One embodiment can include but is not restricted to a radioactivitycorrection method where the thyroid 2 will increase in activity afterthe first few seconds to minutes and this can then be used to create aregion that is designated as thyroid 2. Over time the normal thyroid 2radioactivity will then diminish. One embodiment can include but is notrestricted to a method where the removal of all radioactivity in thethyroid 2 neck region that is diminishing at a given threshold rate orat a given time interval or period is assumed to be thyroid 2 activity.One embodiment can include but is not restricted to a method where allor most of the diminishing activity can then be added or subtracted fromthe image in a manner to include but not restricted to all or a portionof the activity in a manner to include but not restricted to the data 42being altered using a mathematical model that modulates the data 42 by amethod to include but not restricted to a linear or nonlinear or avariable or non-variable manner. In some embodiments the abnormalparathyroid 4 activity, which increases over time either in an absoluteor relative manner relative to the thyroid 2 activity can then be betterimaged after deducing the thyroid 2 activity. One embodiment can includebut is not restricted to a method where all increasing absolute orrelative activity can also be amplified after a specific targetthreshold time in conjunction with subtracting or reducing alldiminishing activity, which is assumed in this model to be thyroid 2activity. In this embodiment the amplification of increasing activitythe parathyroid 4 will become more conspicuous compared to thedecreasing thyroid 2 activity which will become less conspicuous. Oneembodiment can include but is not restricted to a method where therelative levels at which the values amplified or diminished can beadjusted or modulated upward or downward by filters that are absolute orrelative and can have variable curves to include but are not restrictedto non-linear, linear or Gaussian or exponential curve filters or anycombination of filters. Amplification and reduction levels in someembodiments may range from 2 to 10 times the raw data 42 value but arenot restricted to these ranges.

In some embodiments, washout can be used to facilitate detection of theparathyroid. Washout can include but is not restricted to astabilization or a decrease in radioactivity in a target organ that caninclude but is not restricted to the parathyroid 4 or thyroid gland 2.For the parathyroid 4 a substance can be administered to reduceradioactivity uptake to include but not restricted to non-radioactivelabeled sestamibi, calcium, calcium channel blockers or sensipar(cinacalcet). After the administration of the washout substance thewashout rate and imaging and activity can be measured in the parathyroid4. The areas of washout can be compared to the areas of increasinguptake prior to administering of the washout substance. If an area ofincreasing uptake matches the pre-washout substance administration, thenthis helps confirm the probability that the structure that follows thispattern has a high probability of being a representation of theparathyroid gland. A final diagnosis of the location of the parathyroidadenoma may be based on multiple factors and can include theaccumulation of isotopes to include but not restricted to SestamibiTc99m activity in the parathyroid relative to background and to thethyroid activity. Increasing the conspicuity between the parathyroid andthe thyroid assists in this process. Other methods for diagnosing aparathyroid adenoma are based on location of the parathyroid. Changes inthe expected outline of the thyroid or activity located asymmetric,atypically or eccentrically or aberrant relative to the thyroid caninclude but are not restricted to being located lateral or superior orinferior or posterior or anterior or medial or ectopically. A computeraided modeling program can be used to predict thyroid location and caninclude changes in the smooth outline of the thyroid, projection of thethyroid in an asymmetric or eccentric or atypically or aberrantposition, or can be combined with another imaging modality to includebut not restricted to CT, MRI, PET and PET-CT, PET_MR or ultrasound orthermography to predict and define whether the eccentric or asymmetricor atypically or aberrant activity is likely parathyroid activity. Thissame locator modeling can be applied to other body organs to include butnot restricted to adrenal glands, thyroid nodules, bleeding sites andtumors and can utilize Sestamibi Tc 99m and isotopes other thanSestamibi Tc 99m.

Some embodiments can include, but are not restricted to, a localizationmethod where the alignment 1 of the thyroid 2 and the parathyroid 4 canbe improved by registering 1 body structures that take up and transmit50 the Tc Sestamibi, or some other detectability-enhancing substance, toinclude but not restricted to the radioactive body parts, to include butnot restricted to one or more of salivary 5 glands, the heart 37, theliver 38, and external 8 active radioactive markers 32. These bodystructures are distributed at different locations 66 within the body andhave a three-dimensional relationship in the body. These localizingstructures can be chosen to include but are not restricted to bodystructures that do not significantly change their relative position inthe body during the course of the scan. Even though the localizingstructures radioactivity may vary during the scan, the absolute orrelative radioactivity is not the issue and it is the location 66 of thestructure and of its activity that is most pertinent to aligning 1 thebody parts using a method to include but not restricted to twodimensional (2-D) or three dimensional (3-D) modeling 24 or acombination of both 2-D and 3-D modeling 24. By aligning 1 theselocalizing structures a patient can thus move 22 around or even beremoved from the scanner and the image can still be aligned 1 even ifthe patient moves 22 between scans. One embodiment can include but isnot restricted to a method where the data 42 is realigned using amathematical correction for positioning utilizing the expected 3-Dlocation 66 which is then transmuted into a 2-D location 66 of thestructures to compensate for misalignment 1 between scans. This processcan be performed once or more than once to fine-tune or adjust thestatic target locations 66. This method can be combined with othermethods that provide for image alignment 1 or re-alignment 1.

One embodiment can include but is not restricted to a method where thealignment 1 can be augmented using three-dimensional mathematicalmodeling 24 of either the target organs, to include but not restrictedto the thyroid 2 and parathyroid 4 or the non-target organs to includebut not restricted to the thyroid 2 glands, the heart 37, and the liver38 or active nuclear radioactive markers 32.

Another embodiment can include but is not restricted to a method wherethe radioactivity of the non-target organs can be standardized andcorrectional computations performed based on an increase or decrease inradioactive activity over time and then compare this increase ordecrease in radioactivity to but not restricted to the target organ(e.g. thyroid 2 and parathyroid 4 glands).

Another method can use but is not restricted to the use of external 8radioactive markers 32, which can be standardized and the rate of decaymeasured and used to correct for target and non-target organ correctionsor location and activity.

Another method can use but is not restricted to the use of external 8radioactive markers 32, which can be used as localizing markers 32 bywhich alignment 1 can be augmented or achieved and can be combined withother alignment 1 methods to include but not restricted to alignment 1of the target and non-target organ corrections or location and activity.

One embodiment can include but is not restricted to a method where theradioactivity is acquired in a continuous or discontinuous method or acombination of continuous or discontinuous.

One embodiment can include but is not restricted to a method where theradioactivity correction method, the localization method or acombination of the radioactivity correction method and the localizationmethod and other currently utilized methods that can use and include butis not restricted to CT, MRI, Thermography or other imaging techniques.

One embodiment can include but is not restricted to a method where thelocalization is performed with electro-magnetic radiation to include butnot restricted to near infra-red, infra-red, ultraviolet andthermographic imaging device. In one embodiment the patient can berepositioned on the table in the same position by using a method thatincludes but is not restricted to thermography, heat or near infra-red,infra-red imaging or a combination of the above.

In another embodiment the heat sensitive method for localization can beapplied using a superimposed thermographic acquisition or image and thenuclear medicine radioactivity image can be corrected using a method toinclude but not restricted to mathematical correction, filtercorrection, position correction.

In another embodiment the electro-magnetic sensitive method forlocalization can be applied using but not restricted to a superimposedthermographic acquisition or image and the nuclear medicineradioactivity image can be corrected using a combination of methods toinclude but not restricted to mathematical correction, filtercorrection, position correction and the embodiment where the patient canbe repositioned on the table in the same position by using a method thatincludes but is not restricted to thermography, heat or near infra-red,infra-red imaging or a combination of the above.

In another embodiment a heat sensitive method to include but notrestricted to thermography or near infra-red, infra-red detection can beapplied for localizing abnormal parathyroid 4 glands. Heat sensitivemethods are based on the fact that pathological parathyroid 4 glandshave a high blood flow rate and an increased metabolism that producesincreased heat which can be detected by instruments that include but arenot restricted to thermographic or near infra-red, infra-red sensitivedetection devices. These thermographic or infra-red methods anddetectors can be used alone or in combinations with other imagingdetection or localizing devices to be used to include but not restrictedto identify the location 66 of an abnormal dysfunctioning parathyroid 4or thyroid 2 gland, assist in registration and alignment 1 of bodystructure, treatment of abnormal thyroid 2 or parathyroid 4 structuresor any combination of these organs or techniques or methods.

In another embodiment a calcium detection method to include but notrestricted to NMR, Functional magnetic resonance, or magnetic resonanceimaging spectroscopy detection can be applied for localizing abnormalparathyroid 4 glands. The calcium sensitive methods are based on thefact that pathological parathyroid 4 glands have a high blood flow rateand an increased calcium detection or binding or metabolism thatproduces calcium localization which is absolute or relative tosurrounding tissue which can be detected by instruments that include butare not restricted to NMR, Functional magnetic resonance, or magneticresonance imaging spectroscopy detection sensitive detection devices.These NMR, Functional magnetic resonance, or magnetic resonance imagingspectroscopy detection methods and detectors can be used alone or incombinations with other imaging detection or localizing devices to beused to include but not restricted to identify the location 66 of anabnormal dysfunctioning parathyroid 4 or thyroid 2 gland, assist inregistration and alignment 1 of body structure, treatment of abnormalparathyroid 4 or thyroid 2 or structures or any combination of theseorgans or techniques or methods.

One embodiment can include but is not restricted to a method where thelocalization and positioning of the patient is performed with a GlobalPositioning Satellite Tracking Device (GPS 14). The GPS 14 can bepositioned onto the patient in one or more locations 66. In oneembodiment the GPS 14 device can be affixed directly to the body usingvarious methods to include but not restricted to adhesive, tapes,elastic, cloth, can be injected or implanted and Velcro In anothermethod the GPS 14 device can be affixed indirectly to the body using amethod to include but not restricted to a garment, a mask, a frame 10, ahelmet, or an apparatus designed to mold to a body part. The direct andthe indirect methods can be used alone or in combinations.

One embodiment the GPS 14 device can be used but is not restrictedassist in patient positioning. This method can be used to include butnot restricted to assist radioactivity and thermography correction andlocalization methods by more precisely superimposing the body structuresand providing for more accurate image correction. The GPS 14 can be usedfor correction methods and for localization method or a combination ofthe correction method and localization method. The GPS 14 method can beused with currently utilized methods for image creation and quantitativeand qualitative methods that can include but not restricted to CT andPET or correct quantitation to include but not restricted to Gaussian,linear or exponential curve filters.

Local Positioning System/Locators/Device 16.

One embodiment can include but is not restricted to a method where thelocalization and positioning of the patient is performed with a LocalPositioning Tracking Device (LPS 16).

A mobile or fixed coordinate 30 location device 12 replaces the in spacesatellites. The coordinate 30 location 66 similar to ones used in asatellite position is set by the position of the transmitter 50 and orreceiver 51.

An LPS 16 device calculates its position by precisely timing the signalssent by LPS 16 devices strategically placed around the target which caninclude but is not restricted to the patient being imaged. Each LPS 16device continually or periodically, transmits 50 messages that include,the time the message was transmitted 50 and the precise positionalinformation of the LPS 16 device that substitutes for the ephemeris-likebehavior in a GPS 14 device. The LPS 16 receiver or receivers 51 andtransmitter or transmitter 50, which are positioned relative to thetarget that can include but is not restricted to the patient's body or abody part of the patient uses the signals it receives to determine thetransit time of each signal and computes the distance from each LPS 16device. These distances along with the LPS 16 devices locations 66 arecalculated using an algorithm to include but not restrictedtriangulation, trilateration, depending on which algorithm is used, tocompute the position of the transmitter 50 and receiver device 51. Theposition to include but not restricted to the body or body part is thendisplayed on a display that can include but is not restricted to a bodyprofile, a schematic of the body, a moving map, a Cartesian map, adisplay with latitude and longitude and elevation, a display withcranial caudal and anterior-posterior position, The display can includebut is not restricted to displaying animated information, an x-ray, CT,PET scan, Nuclear Medicine, Ultrasound, Photo Acoustic Imaging,Thermographic image and that image can display information to includebut not restricted to anatomic information, physiologic 67 information,radioactivity, instrumentation information, human information to includebut not restricted to receivers 51 or transmitter 50 on the hands,fingers, surgical tools and the information displayed can include but isnot restricted to movement, speed, direction, and change in position.

In the some embodiment six LPS 16 devices are optimal but the number ofLPS 16 devices can be more than or fewer than four LPS 16 transmissiondevices. Fewer than four LPS 16 devices can be used if the LPS 16 deviceknows its position to include but not restricted to 1-D, 2-d or 3-D or4-D (temporal dimension included), which can include but is notrestricted to a fixed receiver 51 on or in the body or body part thatserves as an absolute or relative position in reference to the body.

One embodiment, can include but is not restricted to determining alocation 66 using a mathematical method such as lateralization using theLPD devices that can be on the body in the body, external 8 to the bodyor any combination of on the body in the body, and external 8 to thebody.

In one embodiment a method is used for correcting for the speed of lightwhich is a large value to include but not restricted to a method usingan atomic clock that is as accurate as can be manufactured. In anothermethod a solution for correcting for clock error can include but are notrestricted to using additional antenna or transmitter 50 whose spheresor signals intersect to include but are not restricted to a controlsignal or sphere or surface or computational or constructed fixedcoordinate 30 or coordinates 30.

In another embodiment, the receiver 51 can be constructed to exceedstandard bit speeds of 4,800 bit/sec and can use protocols that do notrequire large ranges but can focus on small areas. By not utilizingstandard GPS 14 this would provide a method that was in compliance withUS Government controls. Also by placing the transmitter 50 below theionosphere one of the major causes of delay can be bypassed.

Another embodiment can include but is not restricted to one or multipleLPS 16 devices. Another embodiment can include but is not restricted toone or multiple GPS 14 devices. Another embodiment can include but isnot restricted to a combination of one or multiple LPS 16 and GPS 14devices.

Another embodiment can include a method for correcting for error if aGPS 14 device is used. An error can occur secondary to delay in signaltransmission through the ionosphere. More than one transmitting 50frequency can be used to correct for ionosphere error by comparingcapture rates for each frequency.

Another embodiment can include but is not restricted to using a moreprecise method called Carrier-Phase Enhancement (CPGPS), which correctfor any incongruity between the phases and can use an additional clockusing a method to include but not restricted to the L1 carrier wavewhich can correct for non-instantaneous imperfect correlation oftransmitter 50-receiver 51 correlation.

Another embodiment can include a method for precision that can includebut is not restricted to Relative Kinematic Positioning (RKP).

Another embodiment can include a method for precision that can includebut is not restricted to using a clock that is not synchronized toCoordinated Universal Time (UTC), a method that is synchronized to GPS14 time, a method that is independent of GPS 14 time and UTC (Non-UTCand non-GPS 14; independent coordinated time (ITC); International AtomicTime (TAI) or any combination of TAI, UTC and GPS 14 and ITC.

In one embodiment ITC can be a time that is set independent of allstandards and is used only for the local LPS 16.

Another embodiment can include a method for precision that can includebut is not restricted to knowing the precise distance between thetransmitter 50, receivers 51 or a combination of transmitter 50 andreceivers. This precise distance can be determined using methods toinclude but not restricted to lasers, ultrasound, and electromagneticmeasuring devices and other methods for measurement to include but notrestricted to kinetic physical measuring techniques to include but notrestricted to rulers.

Knowledge of the fixed distance between transmitter 50, receivers orcombination of transmitter 50 and receivers 51 can be used to set theclock or distance or precision of location 66 more precisely and can beused to eliminate or reduce errors to include but not restricted to thepartial wavelength, wavelength off-set, time incongruence, mathematicalassumptions or any combination of these errors.

Another embodiment to include but not restricted to synchronizing thereceiver 51 and the transmitter 50 clocks using methods to include butnot restricted to one or multiple wavelength sampling and correlationand comparing these wavelengths, tuning the clocks using a method toinclude but not restricted to using the known distance between the fixedreceivers 51 and transmitter 50 to synchronize and correlate time anddistance using one or multiple wavelengths, lasers, or otherelectromagnetic or non-electromagnetic measuring tools. Some embodimentsmay include but is not restricted to triple differencing which subtractsthe receiver differences from Time A compared to that of Time B. In oneembodiment the triple difference method can use three independent timepairs to solve for a receiver's location 66 position.

In one embodiment a mobile or fixed LPS 16 can be positioned onto thepatient in one or more locations 66. In one embodiment the LPS 16 devicecan be affixed directly to the body using various methods to include butnot restricted to adhesive, tapes, elastic, cloth and Velcro, In anothermethod the GPS 14 device can be affixed indirectly to the body using amethod to include but not restricted to a garment, a mask, a helmet, oran apparatus designed to mold to a body part. The direct and theindirect methods can be used alone or in combinations.

One embodiment the LPS 16 device can be used but is not restrictedassist in patient positioning. This method can be used to include butnot restricted to assist radioactivity and thermography correction andlocalization methods by more precisely superimposing the body structuresand providing for more accurate image correction. The LPS 16 can be usedfor correction methods and for localization method or a combination ofthe correction method and localization method. The LPS 16 method can beused with currently utilized methods for image creation and quantitativeand qualitative methods that can include but not restricted to CT andPET or correct quantization to include but not restricted to Gaussian,linear or exponential curve filters.

In another embodiment the methods for localization described above canbe applied to an organ or structures other than the parathyroid 4 orthyroid 2 and can include but is not restricted to the musculoskeletalsystem to include but not restricted to an ACL 70 graft placement,hardware 26 surgical placement of the 19 and surgery to other body parts(not depicted) to include but not restricted to the kidney, heart 37,neural structures, glands, muscles, endocrine and neuro-endocrine tissueand tissue of ectodermal, endodermal and mesodermal origin and caninclude but is not restricted to normal and abnormal tissue to includetumors and non-tumor tissue and hyper-functioning and abnormalfunctioning tissue as well as normal functioning tissue and thetechniques can be used for but not restricted to diagnosis andtreatment.

In another embodiment the distance between the locators 12 and thereceptors 20 can be calculated and incorporate using electromagneticwavelength to include but not restricted to lasers and ultrasound.

Locator 12 and sensors 20 can be used to both transmit 50 and receive 51signal or any combination of transmit 50 and receive 51.

In another embodiment the methods for image correction can be to anorgan or structures other than the parathyroid 4 or thyroid 2 and caninclude but is not restricted to the musculoskeletal system to includebut not restricted to an ACL 70 graft placement, hardware 26 surgicalplacement of the knee 19 and surgery to other body parts to include butnot restricted to the kidney, heart 37, neural structures, glands,muscles, endocrine and neuro-endocrine tissue and tissue of ectodermal,endodermal and mesodermal origin and can include but is not restrictedto normal and abnormal tissue to include tumors and non-tumor tissue andhyper-functioning and abnormal functioning tissue as well as normalfunctioning tissue and the techniques can be used for but not restrictedto diagnosis and treatment. The hardware 26 can also containtransmission 50 and receiver 51 devices 20 to insure proper positioningin the body.

FIG. 5 depicts a sensor, detection or diagnostic or treatment assistancedevice 20 that can utilize include but is not restricted to anelectro-magnetic, kinetic/mechanical or heat energy or any combinationsof these energies as the energy being detected. These can include butare not restricted to electromagnetic, ionizing radiation, cold, heat,thermography, ultraviolet, infra-red, nuclear energy, ultrasound, sound,color, light, or movement. In one of the embodiment's thermography canbe used alone or in combination with one or more of the other energydetection or imaging devices 20 to identify, image or localize theparathyroid 4 and the thyroid 2.

Another embodiment can include using a sensing device 20 to identify theparathyroid 4 and thyroid 2 as well as other body parts. The sensor caninclude but is not restricted to a heat sensing parathyroid 4identification method that is used to include but not restricted tomechanical and electromagnetic, photonic or optical readings moresensitive than the human eye can detect, thermography, heat sensitivityand near infra-red, infra-red detection or imaging or a combination ofimaging and detection where these methods can be used to identify anddiagnose the location 66 of the abnormal parathyroid 4 gland which ismore vascular and exudes more heat than other less vascular thyroid 2.This can be used for diagnosis or treatment or a combination ofdiagnosis and treatment to include but not restricted to the use of nearinfra-red, infrared other electromagnetic wavelength analysis. Anembodiment can include but is not restricted to a heat sensingparathyroid 4 identification method where the thyroid 2 tissue issuppressed and the vascularity reduced, which reduces the heat generatedby the thyroid 2 and provides greater conspicuity between theparathyroid 4 and the thyroid 2 and allows the parathyroid 4 to be moreeasily detected. One method for reducing thyroid 2 activity can includebut is not restricted to propylthiouracil and methimazole (Tapazole) andthiourea and thiouracil and their derivatives or other thyroid 2reducing or increasing agent that can include but are not restricted toantibodies or peptides or other organic or inorganic compounds orelements that can include but are not restricted to thyroid 2stimulating hormone (TSH) or thyroid 2 releasing hormone (TRH) or agentsthat block TSH or TRH that can include but are not restricted toantibodies or immune mediated receptor or transmitted structures.

Another embodiment can include but is not restricted to a heat sensingparathyroid 4 identification method where the parathyroid 4 gland ishyper-stimulated using methods to include but not restricted to theadministration of thiazide derivatives such as hydrochlorothiazide, orinorganic phosphates. The stimulation of the abnormal parathyroid 4increases the heat production and blood flow of the parathyroid 4 glandthyroid and provides greater conspicuity between the parathyroid 4 andthe thyroid 2 and allows the parathyroid 4 to be more easily detected.

One embodiment can include but is not restricted to a method where thestandard Tc-99 Sestimibi is used in conjunction with a method where thethyroid 2 tissue is suppressed and the vascularity reduced which reducesthe radioactive uptake by the thyroid 2 or increases the uptake by theparathyroid 4. This can provide greater conspicuity between theparathyroid 4 and the thyroid 2 and allows the abnormal parathyroid 4gland to be more easily detected. One method for reducing thyroid 2activity can include but is not restricted to propylthiouracil andmethimazole (Tapazole) and thiourea and thiouracil and their derivativesor other thyroid 2 reducing or increasing agent that can include but arenot restricted to antibodies or peptides or other organic or inorganiccompounds or elements that can include but are not restricted to thyroid2 stimulating hormone (TSH) or thyroid 2 releasing hormone (TRH) oragents that block TSH or TRH that can include but are not restricted toantibodies or immune mediated receptor or transmitted structures. Thisrepresents a new uses for these thyroid 2 suppression medications. Thiscan be given prior to the Tc-99 Sestimibi injection and imaging.

Another embodiment can include but is not restricted to a method wherethe standard Tc-99 Sestimibi is used for detection and localization ofthe abnormal parathyroid 4 gland in conjunction with a method where theparathyroid 4 gland is hyper-stimulated. The stimulation of the abnormalparathyroid 4 increases the uptake and radioactivity of the parathyroid4 gland and provides greater conspicuity between the parathyroid 4 andthe thyroid and allows the abnormal parathyroid 4 gland to be moreeasily detected. One method for hyper-stimulating the parathyroid 4gland can include bit is not restricted to the administration ofthiazide derivatives such as hydrochlorothiazide, or inorganicphosphates. In another embodiment parathyroid 4 modulating medicationscan be used to improve the treatment or identification or localizationof the parathyroid 4 hormone and can include but are not restricted tosinacalcet, or a calcium channel agonist, a calcium channel antagonisticor an agonist or antagonist or the parathyroid 4 hormone or a variationon the Parathyroid 4 hormone (PTH) amino acid polypeptide to include butnot include the active component of the parathyroid 4 hormone or avariation on the active component or the intact or non-intactparathyroid 4 hormone. These medications can be administered prior toduring or after the imaging or treatment or procedure or combination ofthe procedures for both for the localization, diagnosis and/or treatmentof parathyroid function and dysfunction or metabolism.

In some embodiments, detectability of the parathyroid 4 may be affectedby administering an agent that alters the sensitivity of the sensingreceptors in the parathyroid, such agents can include agents that act oncalcium to include but not restricted to cinacalet and other elements orsubstances to include but not restricted to phosphous, magnesium,manganese and bisphosphonates to include but not restricted toalendronate, ibandronate, risedronate and zoledronic acid.

Detectability of the parathyroid may be affected by administeringSensipar (cinacalcet), which is a calcimimetic agent that increases thesensitivity of the calcium-sensing receptor to activation byextracellular calcium. Sensipar (cinacalcet) tablets contain thehydrochloride salt of cinacalcet. Its empirical formula is C₂₂H₂₂F₃N.HClwith a molecular weight of 393.9 g/mol (hydrochloride salt) and 357.4g/mol (free base). It has one chiral center having an R-absoluteconfiguration. The R-enantiomer is the more potent enantiomer and hasbeen shown to be responsible for pharmacodynamic activity.

One embodiment can include a method where the electromagnetic lightspectrum is used to localize or stimulate or repress an organ to includebut not restricted to a parathyroid 4 gland or hyperplasia or anadenoma. A parathyroid 4 adenoma because of its unique cellular make-upand its blood supply is orange-red. Using a method where a specificwavelength in the electromagnetic spectrum is assigned to theparathyroid 4 to include but not restricted to a central rangeapproximating 590 to 625 nm the reflection, translucence, transducingcapacity or the absorption of this wavelength can be used to detect andlocalize a parathyroid 4 adenoma. Depending on the size and vascularityof the parathyroid 4 adenoma the specific wavelength may vary from thisrange. The method can be used to distinguish the parathyroid 4 tissuefrom the adjacent supportive tissue and the thyroid 2, which have areflection, translucence, transducing capacity or the absorption of thiswavelength different from the parathyroid 4 adenoma. Other specificelectromagnetic wavelengths can be used to identify other organs or bodytissues. This method can include but is not restricted tophotospectroscopy.

The target body organ can be interrogated before or after or while beingexcited by an internal (not depicted) or external 8 energy method orsource 74 to include but not restricted to electromagnetic, kinetic,heat, mechanical and ultrasound 25. In another embodiment the localtissue can measured for heat absorption or heat sumps. In anotherembodiment the heat sumps or reduction in heat or the heat increases canbe measured when an external or internal heating source is applied tothe tissue being interegated for diagnostic or therapeutic purposes andthe heat addition or reduction/dissipation is measured by a sensor orimaging method 20 to include but not restricted to x-ray, CT, PET scan,Nuclear Medicine, Ultrasound 25 (depicted), Thermographic imaging and inone embodiment is studying and relating to blood flow and heat sumpcalculations in the tissue body region being interrogated.

FIG. 6 depicts on example of a frame 10 that can be used to maintain orfix a body part relative to the body or the target organ or structure 12or body. In some embodiments, the target organ is the thyroid 2 and theparathyroid 4. In another embodiment frames or frame 10—like devices canbe used to but are not excluded to being used to fix in place theradioactive sources, the positioning devices, surgery and surgicalassistance devices, and to fix a structure in a fixed or relativelyfixed mechanical position and can include a garment, a mask, a helmet,or an apparatus designed to mold to a body part to include but notrestricted to caps, frames 10, bands, garments. An external 8 source canalso be attached to the body using methods of attachment to include butnot restricted to adhesives, bandages, membranes, injections into theskin 60, sutures in the skin 60, bands and Velcro and straps, earrings,tattoos, and skin 60-piercings or internal and external 8 methods can beused and combined to include but not restricted to swallowed, inhaled,injected, place onto, into or through the skin 60 or mucosa 60 or anorifice. The marker or fixation 10 device can be composed of but is notrestricted to a gel that can also serve as a marker for other imagingdevices to include but not restricted to MRI, CT, thermography, orultrasound.

FIG. 7 is an imaging device which can be but is not restricted to anultrasound transducer with a corresponding imaging technique 27, whichincorporates a positioning device or locator 12 that can transmit 50 andreceive 51 signals that can be identified and recorded within thecoordinates 30 of the GPS 14 or LPS 16 coordinate 30 system or a sensingdevice 20. The transmitter 50 and receiver 51 that can be incorporatedinto the transducer can be measured in real-time and the outline of thethyroid 2 can be temporally mapped such that when the transducer ismoved to outline a structure to include but not restricted to thethyroid 2 or parathyroid 4 then that outline of the body part can betransmitted to the coordinate 30 system such that the body partincluding but not restricted to the thyroid 2 and parathyroid 4 can bedesignated and located in space using the GPS 14 or LPS 16 coordinate 30system.

FIG. 8 is a prosthesis or medical hardware 26 or implant 26 or implanteddevice 26 into the body in this case a hip 18 that can be referred to ashardware 26 that can incorporate one or more positioning or locator 12devices or sensor 20 that can transmit 50 and 51 signals that can beidentified and recorded and coordinated with the coordinates 30 of theGPS 14 or LPS 16 coordinate 30 system.

In FIG. 8 and FIG. 9 the transmitter 50 and receiver 51 of the locator12 or sensor 20 can be incorporated into the hardware 26 and can beincorporated in the body part and can be measured in real-time and theirrelationship can be measured and they can be temporally mapped such thatwhen the hardware 26 is moved or positioned 22 or permanently placed inposition it can be located and monitored and positioned relative to theremainder of the coordinates 30 and most importantly relative to otherbody parts can be transmitted to the coordinate 30 system such that thehardware 26 and the body part can be designated and located in spaceusing the GPS 14 or LPS 16 coordinate 30 system. The application ofthese methods and embodiments can include but is not restricted tointegrating these methods and processes and embodiments with or into aComputer Assisted/Aided Device (CAD) or platform or program or GPS 14 orLPS 16 and can be used with an imaging device to include but notrestricted to CT, MRI or Ultrasound. One of the challenges of prostheticand hardware 26 stability is laxity and instability and movement. Thesensors 20 and locator 12 can include positioning such that theprosthesis and the native body part both contain one or more sensors 20or a locators 12 such that when there is separation from the native bodystructure this can be determined and measured for motion and separationand stability of the prosthesis or implant or hardware 26 or device 26relative to the native body part. Thus this embodiments use can includebut is not restricted to plan, implant and monitor the implant orprosthesis or medical device 26 both prior to during and after theplacement of the implant or prosthesis or medical device 26 relative tothe body part. This coordinate system can be used with GPS 14 and LPS 16alone or in conjunction with other imaging methods including but notrestricted to Computed Tomography (CT), Ultrasound (US), MagneticResonance Imaging (MRI), Thermography, or other imaging and/orpositioning techniques.

An implantable device to which one or more sensors 20, locators 12, andmarkers 32 can be affixed to or implanted can include but is notrestricted to a prostheses, a delivery device, a locator, a transmitter,a receiver, a sensing device, hardware to include but not restricted tomedical hardware, screws, nails, rods, plates, imaging modules orapparatuses, parts of or complete artificial joints, organs, muscles,ligaments, tendons and other body part replacements, native andnon-native, xenograft and allograft and homograft, identical andnon-identical donor material or body part, machines, sensors, flowdevices, and electromagnetic and kinetic and heat and ultrasound andmechanical energy devices, endoscopes, transducers and treatmentapparatuses. One or more locators can be positioned or placed inside oroutside of the body and relative or absolute measurements can beobtained to determine the relationship of one locator relative to theother one or more locators and these measurements can include but arenot restricted to distance, anglulation, orientation, The locators canbe associated with but not restricted to one or more probes or scalpelsthat can be associated with or have affixed or incorporate the one ormore than one first locators that can but is not restricted to contain acompass, altimeter, accelerometer or protractor, ruler or othermeasuring device that can be digital or analog or mechanical in natureand can inform the user of measurements that can include but are notrestricted to axies, distance, anglulation, or orientation of the one ormore than one locators or probe or scalpel and can be related to a bodypart or the one or more than one second location or locators.

In one preferred embodiment, the body part can be the knee and theimplanted device can be an ACL graft. The graft can contain one or morelocators which in the preferred embodiment can be at the opposite endsof a portion of the graft. Additional locators can be positioned on ornear the tibia and fibula where the graft tunnels are to be drilled witha surgical instrument to include a bone drill. The drill or drill bitcan include locators or sensors that can include but is not restrictedto contain a compass, altimeter, accelerometer or protractor, ruler orother measuring device that can be digital or analog or mechanical innature and can inform the user of measurements that can include but arenot restricted to axies, distance, anglulation, or orientation of theone or more than one locators or probe or scalpel that can relate thegraft to the body parts to include the tibia and fibula bone. Theinformation from the locators of the graft or locators of or near thetibia and fibula or the surgical instruments or probes can communicateto a computer which can include but is not restricted to a CAD programor a 2-D or 3-D map of the graft and bones body parts being surgicallyrepaired. Feedback from the analysis devices and computers or thelocators can then be analyzed and the measurements that can include butare not restricted to the axies, distance, anglulation, or orientationcan be determined and corrected such that the drill bit and thesubsequent tunnels for the graft in the tibia and fibula can bedetermined and the graft can be placed in its proper orientationrelative to the tibia and fibula. This same method or system can be usedfor other body parts. This method and system can be combined otherimaging methods and can be combined with or performed by roboticsurgery.

FIG. 9 is a prosthesis or medical hardware 26 or implants or device 26that can incorporate one or more positioning or locator devices 12 orsensors 20 that can transmit 50 and receive 51 signals that can beidentified and recorded and coordinated with the coordinates 30, 66 ofthe GPS 14 or LPS 16 coordinate system 30 or a sensory feedback unitsand is viewed in relationship to a body part in this case a knee 19.FIG. 9 is a depiction of a knee 19 with a locator 12 that can positionan ACL graft 70 or Knee 19 prosthesis 26 in the correct position andangle in the bones of the knee 19 to include the femur tibia and fibula.The ACL 70 graft can also contain a sensor 20 that can monitor theintegrity of the ACL 70 in real-time and measure stresses on the ACL 70and can measure integrity of the ACL graft 70 prior, during and afterimplantation. In this depiction the sensor 20 can include but are notrestricted to measure tensile strength, stretch, thickness, heat, bloodflow, specific blood particles such as red and white blood cells andposition relative to other locators 12 implanted in the body part whichin this embodiment include the femur and tibia. This same or similarmethods and devices and applications can be applied to other body partsor implants/hardware 26.

FIG. 10 depicts an elastomeric gel Mill marker that utilizes a blockcopolymer with lipophillic, lipid, oil or fat-like material and ahydrophillic or water-like material and elastomeric gel marker which caninclude and be constricted to include variable thicknesses and shapesincluding an annular marker with an area that can serve as a conduit 33through which a needle or object can be passed.

Although these gels can be manufactured with all possible combinationsof polymers depending on the T1 and T2 weighted imaging characteristicsdesired, some embodiments can employ a triblock copolymer composed of 25to 75% lipophillic, fatty materials or oils but can include percentagesof lipophillic, oil or fat material that are less than 25% fattymaterials or oils or greater than 75% fatty materials or oils and caninclude all combinations of oil and fatty materials and water orhydrophillic materials. In the current embodiment the gel can includebut is not restricted to be encapsulated fully or partially with amembrane or coating that can include but is not restricted to a firm orflexible or plastic or wax covering. The gel markers 32 can be producedwith no membrane or the gel marker can have no coating or membrane 31that can include but is not restricted to a plastic-like material, clothmaterial, or other organic or inorganic materials.

The gel markers 32 can be attached, associated or incorporated to arigid or flexible frame 10 that can but is not restricted to conformingto a body part.

The gel markers 32 can be tacky or not tacky. The gel markers 32 caninclude but are not restricted to include adhesives, velcro or othermethods to fasten the marker to the body. One embodiment can include agel marker that is attached, associated or incorporated to a rigid orflexible frame 10 or a material that can fix the marker to one or morebody parts and is a material that can be but is not restricted to astretchable material that is made of an elastomeric gel, a cloth-likematerial, a stretchable cloth material such as but not restricted toCOBAN ©, a plastic or a fiber optic or a silicon based material or anorganic or synthetic material.

FIG. 11 depicts a gel markers 32 that can be solid or hollow and caninclude but are not restricted to include a reservoir 34 and/or aconduit and can be filled prior to, during or after the manufacturing orthe imaging procedure. The gel marker can contain or be incorporatedinto or associated with a sensor or a locator that can include but isnot restricted to a computer chip, a transmitter 50 or receiver 51locator 12, radioactive material, a crystal, or an organic ornon-organic material that can be used as but not restricted to a sensoror locator that can detect, or convert, heat, kinetic, electromagnetic,ultrasound, odors, visible, auditory, gustatory/taste and sensory/touchsignals input into an output that can be converted to but not restrictedto a quantified or qualified signal to be used to assess input or usedfor another output.

FIGS. 10 and 11 depict the gel markers 32 can contain or incorporate oneor more than one CT and X-ray dense materials, that can include but arenot restricted to ferro-magnetic and non-ferromagnetic materials thatcan include but are not restricted to radioactive materials, gadolinium,iodine, lead, iron, copper, proteins, waxes, water, gas, vacuums andoils as well as other solids and liquids and gases.

The gel markers 32 can contain or incorporate one or more than one MRhypointense, isointense or hyperintense materials, that can includeferro-magnetic and non-ferromagnetic materials that can include but arenot restricted to radioactive materials, gadolinium, iodine, lead, iron,copper, proteins, waxes, water, oxygen and carbon dioxide and nitrousoxide gas, vacuums and oils as well as other solids and liquids andgases.

The gel markers 32 can contain or incorporate one or more than oneUltrasound highly reflective or poorly reflective or hyperechoic,isoechoic or hyporechoic materials, that can include but are notrestricted to radioactive materials, gadolinium, iodine, lead, iron,copper, proteins, waxes, water, oxygen and carbon dioxide and nitrousoxide gas, vacuums and oils as well as other solids and liquids andgases.

The gel markers 32 can contain or incorporate one or more than oneradioactive materials or radioactive absorbing or blocking materialsthat can include can include radioactive 9-magnetic and non-radioactivematerials that can include but are not restricted to radioactivetechnecium, iodine, and can include but are not restricted to othermaterials such as gadolinium, iodine, lead, iron, copper, proteins,waxes, water, oxygen and carbon dioxide and nitrous oxide gas, vacuumsand oils as well as other solids and liquids and gases.

The gel markers 32 can contain or incorporate one or more than onethermophillic or thermophobic or thermo-absorbtive materials, that caninclude but are not restricted to radioactive materials, asbestos,zeolite, fiberglass, gadolinium, iodine, lead, iron, copper, proteins,waxes, water, oxygen and carbon dioxide and nitrous oxide gas, vacuumsand oils as well as other solids and liquids and gases.

The gel markers 32 can contain or incorporate one or more materials 16that can include one or more solid or liquid or gel or gas materialsthat can include and can utilize electromagnetic absorbing or reflectingmaterials that can be specifically used for but not restricted tovisible wavelength or ultraviolet or infrared wavelength materials thatcan include but are not restricted to radioactive materials, asbestos,zeolite, fiberglass, gadolinium, iodine, lead, iron, copper, proteins,waxes, water, oxygen and carbon dioxide and nitrous oxide gas, vacuumsand oils as well as other solids and liquids and gases.

The gel markers 32 can be cut or created or formed or shaped to includedifferent geometric configurations to include but not restricted toellipse, circle, rectangle, square or triangles and polygons andvariable thicknesses to include but not restricted to one embodiment of1 to 10 mm but can be greater or less than 1 to 10 mm. In someembodiments, the shape will be a shape that is not confused withanatomic shaped objects to include but not restricted to acute andobtuse angled structures and perfect circular objects. Markers 32 can beannular or non-annular. The markers 32 can include but not restricted toconformation to the body, or being thin enough yet still definableenough to be identified as a marker 32. The markers 32 can contain acentral area void of gel that can serve as conduit to include but notrestricted to needle placement for biopsies and for the passage ofobjects to include solids and liquids and gels and gases and these solidobjects can be placed onto, into or through the skin 60 or adventitia orfascia or body part.

T1 weighted compounds for this application are considered and includebut are not restricted to fatty acids, fats and oil. T2 weightedcompounds for this application are considered and include but are notrestricted to water and hydrophillic compounds. As a reference using a‘true’ spin echo sequence a T1 or fat or oil compound will behyperintense or ‘bright’ on T1 with a TR of 500 and a TE of 12 and a T2or water or hydrophillic compound will be hyperintense or ‘bright’ on T2with a TR of 3000 and a TE of 80.

In some embodiments the marker 32 includes a first material having ahyperintense T1 value for a repetition time (TR) of 400 TO 600 and anecho time (TE) of 8 TO 14 and a second material having a hyperintense T2value for a TR of 2500 TO 4000 and an echo time (TE) of 70 TO 110 usinga 1.5 Tesla magnet.

MRI utilizes many techniques and physical properties of substances forimaging and for physiologic identification and this is defined anddetermined by subjecting the substance to different MR sequences. Two ofthe most common sequences or mechanisms for defining a substance are T-1weighting and T-2 weighting. In general a T-1 weighted sequence resultsin body fat and can include but is not restricted to human subcutaneousfat, a non-human fat, or oil-like or lipophilic substance appearingbright or more intense than human water to include but not restricted toCerebrospinal fluid (CSF), water or hydrophilic substance. Whereas, ingeneral a T-2 weighted sequence results in human water to include butnot restricted to Cerebrospinal fluid (CSF), a water or hydrophilicsubstance appearing bright or more intense than body fat and can includebut is not restricted to human subcutaneous fat, fat or oil-like orlipophilic substance.

T-1 sequences utilize Spin-Lattice relaxation time. Spin-latticerelaxation is the mechanism by which the z component of themagnetization vector comes into thermodynamic equilibrium with itssurroundings (the “lattice”) in nuclear magnetic resonance (NMR) andmagnetic resonance imaging (MRI). It is characterized by thespin-lattice relaxation time, a time constant known as T₁. It is namedin contrast to T₂, the spin-spin echo relaxation time. The spin-spinrelaxation is the mechanism by which M_(xy), the transverse component ofthe magnetization vector, exponentially decays towards its equilibriumvalue of zero, in nuclear magnetic resonance (NMR) and magneticresonance imaging (MM). It is characterized by the spin-spin relaxationtime, known as T2, a time constant characterizing the signal decay. Itis named in contrast to T₁, the spin-lattice relaxation time. It is thetime it takes for the magnetic resonance signal to reach 37% (1/e) ofits initial value after its generation by tipping the longitudinalmagnetization towards the magnetic transverse plane. T2 relaxationgenerally proceeds more rapidly than T₁ recovery, and different samplesand different biological tissues have different T2. For example, fluidshave the longest T2s (in the order of seconds for protons), and waterbased tissues are in the 40-200 ms range, while fat based tissues are inthe 10-100 ms range. Amorphous solids have T2s in the range ofmilliseconds, while the transverse magnetization of crystalline samplesdecays in around 1/20 ms. T2-weighted scans are another basic type. Likethe T1-weighted scan, fat is differentiated from water, but in this casefat shows darker, and water lighter. For example, in the case ofcerebral and spinal study, the CSF (cerebrospinal fluid) will bebrighter or lighter or more intense in T2-weighted images. These scansare therefore particularly well suited to imaging edema, with long TEand long TR times.

MRI sequences that can be viewed using the elastomeric marker 32 caninclude but are not restricted to T-1 spin echo, T-2 spin echo, Gradientecho, turbo spin echo sequences, spectroscopy and inversion recoverysequences including fluid attenuated inversion recovery (FLAIR) andShort T-1 Inversion Recovery (STIR) imaging.

Various embodiments of the gel marker can include but are not restrictedto variable combinations of T1 and T2 weighted materials. Thesecombinations can be innate to the materials composing the gels and caninclude hydrophillic to include but not restricted to water abundant andcan be lipophillic materials to include but not restricted to oil andfat abundant materials; or the materials can be interlaced or embeddedinto the gel to include but not restricted to being located withinlayers of the gel or can be separate from the gel to include but notrestricted to a reservoir 34.

In some embodiments the shape has a configuration such that it is not anatural biologic structure and can include structures such as triangles,squares, circles, ellipses, pentagons, and other polygons, especiallyones that have acute and obtuse angles and one or more non-anatomicangles. In some embodiments, the elastomeric gel MRI marker may havethree unique and important characteristics that when combined produce anexcellent MRI marker. First, the marker may be composed of an admixtureof fatty oils (T1 shortening) and water elements (T2 shortening) thatcoexist. Second, the marker may be appropriately sized to the anatomybeing interrogated. Third, because the material is an elastomeric gel itmay be configured to readily conform to superficial structures withoutsignificant anatomic compression or distortion. The gel MRI marker mayprovide reliable visualization on a plurality of appropriate sequences,have an absence of artifacts, have a variety of sizes and shapesappropriate for the multiple anatomic sites and the various applicationbeing investigated, impose minimal to no distortion of the localanatomy, have the ability to conform to the contours of the localanatomy, have a non-anatomic shape so it will not be confused withbiological structures, be easy to use and adhere to skin 60, bebiologically safe and non-toxic with MRI use, preferably not use aliquid which can spill, be inexpensive to produce, and be highlydetectable multiple non-visual imaging modalities to include but notrestricted to MR, CT and Ultrasound.

The elastomeric markers 32 can have both T1 and T2 characteristics. TheT1 characteristics can vary greatly. The contrast resolution between T1and T2, or fat containing and water containing or lipophilic andhydrophilic tissues can be differentiated in similar organ's tissue, asis the case but not restricted to the difference between scalp fat andbrain white matter, grey matter and cerebrospinal fluid (CSF). On the T1sequence the signal intensity on a T1 weighted sequence is greatestwithin the scalp fat followed by the white matter. The grey matter isless intense than the white matter but more intense than the CSF. On T2weighted sequences the CSF is most intense followed grey matter, thenwhite matter then scalp fat in decreasing intensity. The MRI marker 32can be constricted to be generic or specific to the tissue to which itlies adjacent. In one embodiment, if the marker 32 is adjacent to thescalp fat it will need to be distinguishable from scalp fat and the skinon both T1 and T2 sequences. If the marker 32 is adjacent to the CSF ora water-containing cyst in the scalp it will need to be distinguishablefrom the CSF or the water-containing cyst of the scalp, therefore theoptimal T1 and T2 characteristics of the marker 32 can and may even needto or at least benefit from varying from a single generic one-fits-allmarker 32. It is recognized that a generic marker 32 can be beneficialin many cases but not in many or in all cases. Therefore the marker 32can vary widely in its T1 and T2 characteristics and still be effective.Therefore specific and optimal marker 32 T1 and T2 characteristics varydepending on the adjacent tissue and secondarily on the sequences beingutilized and the primary principal is that the marker 32 can bedistinguished on T1 and T2 weighted sequences and their derivativesequences to include but not restricted to spin echo, STIR, FLAIR,Diffusion, turbo-spin echo, and gradient echo and even flow sequences.In this embodiment most if not all sequences can be derived from T1 andT2 weighted sequences.

The marker 32 if used in x-ray and x-ray related imaging to include butnot restricted to CT will need to vary in density relative to theabsorptive property of the x-ray beam that is utilized and can bedependent upon but is not restricted to the KV (kilovolt) and Ma(milliamps) that are more typically used in these forms of x-rayimaging. The marker 32 s density can be created by but not restricted tothe density of the gel or the gel can contain ferromagnetic ornon-ferromagnetic particles. In one of the preferred embodiments thatcontains particles, the particles can include but are not restricted toorganic or inorganic materials, to include but not restricted to gels,plastics, elements that are ferromagnetic such as iron and nickel orcobalt or can be paramagnetic such as barium calcium, aluminum,magnesium and platinum or can be non-ferromagnetic such as or non—suchas copper, lead, and silver.

If the marker 32 is used in nuclear medicine then its absorption ofnuclear energy and the particles and energy released by differing formsof decay need to be considered and include but are not restricted toalpha, beta and gamma radiation. If the marker 32 is used in ultrasoundthen the acoustic properties need to be considered and include but arenot restricted to altering the acoustic signal using solids, liquids,gels or gases or any combination or mixture of these structures. Thetendency to conduct or induce a current needs to also be considered ifthe marker 32 is to be used in MR and can include but is not restrictedto iron and needs to consider the effect of RF on the materials beingused to prevent heating or the induction of currents.

Depending on the materials used then the shape of the marker 32 may bepertinent and can include but is not restricted to circles and spiralsespecially if these are repeating or overlapping in structure. In oneembodiment a gel marker 32 can be impregnated with particles that areweakly paramagnet or non Ferro-magnetic or paramagnetic and weaklyRadiofrequency (RF) reactive such as but not restricted to plastics andelements such as Barium or gadolinium. The particle sizes can vary andin the embodiment are in the Pico-meter to nanometer to micrometer size.

For the purpose of this application the terms activity and intensity maybe used interchangeably and can refer to data derived from the livingcreature or target or can be processed data from a computer or imagingor collecting or display device.

Variations in the chemical quantitative composition of the marker 32,which are known to the MR interpreter, can be used as standards toassess chemical composition of body structures using various knownstandards. This can be applied to body composition and physiology andhealth to include but not restricted to bone marrow composition, fattyand fibrotic liver, osteoporosis, diabetes and pancreatic fattyreplacement, distinguishing adenomas form aggressive tumors, generalbody fat calculations, metabolic replacement diseases and tumors.

In one embodiment a series of marker 32 standards can be place on ornear the surface of the living creatures' body which can include but isnot restricted to the marker 32 s neatly affixed within a housing orframe or structure. The standards can include one or more than onestandard. In one embodiment the optimal number of standards can includebut is not restricted to be an odd number of standards with one or morestandards being in the normal range and one or more standards lyingoutside of the normal range for that specific organ. The organ caninclude but is not restricted to include the liver, the bone marrow, andthe pancreas. In the case of the liver the standards the first substancecan be composed of a lipophilic or fat and the second substance or themore than the second substance being a non-fat material preferably butnot restricted to a water or hydrophilic substance. The percentage ofthe first and the not-first second substance can be varied to simulatenormal and abnormal relationships or ratio of fat and non-fatsubstances. The same principles can be applies to other organs includingbut not restricted to the pancreas. For other organs such as bone therecan be fat and one or more than one non-fat substance which in someembodiments the more than one non-fat substance can include but is notrestricted to calcium-hydroxyapatite and water based substances tosimulate the bone structure. In some embodiments these substances canbut are not restricted to be combined to simulate normal bone atvariable ages, to simulate changes in the normal architecture of bonecrystals to include but not restricted to normal bones, osteopenic andosteoporotic bones and bones that are more dense than normal and thesecan include but are not restricted to include both the density and thearchitecture of the bones, and the marrow and fact content of thesebones.

Although in some embodiments these standards will be used with MRI thesestandards are not restricted to MR and can be used with CT andultrasound and nuclear medicine. Although in some embodiments thesestandards will be elastomeric or gel compounds, these marker 32 s arenot restricted to elastomeric compounds and can include non-elastomericand non-gel substances such as other solids and liquids and gases.Variations in the chemical quantitative composition of the marker, whichare known to the MR interpreter, can be used as standards to assesschemical composition of body structures using various known standards.This can be applied to body composition and physiology and health toinclude but not restricted to bone marrow composition, fatty andfibrotic liver, osteoporosis, diabetes and pancreatic fatty replacement,distinguishing adenomas form aggressive tumors, general body fatcalculations, metabolic replacement diseases and tumors.

The application of these methods and embodiments can include but is notrestricted to integrating these methods and processes and embodimentswith or into treatment of parathyroid 4 gland dysfunction and functionand other body part functions and dysfunctions. Surgical andnon-surgical and robotic approaches to parathyroid 4 and other body partfunctions and dysfunctions treatment can benefit from preciselocalization of the abnormal parathyroid gland 4 and localizationtechniques described in this patent can be combined with surgical andinvasive, minimally invasive, tightly targeted minimally invasive andnon-invasive treatment techniques to include but not restricted toenergetic or mechanical/kinetic, or biologic that can include but is notrestricted to Radiofrequency ablation (RF) and microwave (MW) and laser(L), Cryotherapy (CryT), High Intensity Focused Ultrasound (HIFU),Radioactive Therapy (Brachytherapy: BrT), Irreversible, Electroporation(IRE), Electrical Current Therapies, Electrocautery, Magnetic Resonance(MR), Ultrasound, (US), Thermal energies both heat and cold andmechanical or kinetic energies and with adjuvant combinations that caninclude but are not restricted to medication delivery, Medicationpackets, blood flow reduction, Chemical and Medication Ablation,Activation and Deactivation and Modulation Therapy, Adhesives and Gluesand Molecular Crystal and Lattice therapies, Target Tissue DeliveryDevice Therapies, Peptide and Biological Conversion Therapies, MR and RFand Magnetic External 8 Heating Therapies, Hyperthermia with AdjuvantTherapy, Hypothermia with Adjuvant Therapy, Local protective therapy inthe Vicinity of the Target Organ Therapy, Suction and Expansion Therapy,Positive Pressure and Expansion Therapy, Mechanical Ablation Therapy andCombinations and biologic and nonbiological procedures that can includeimmune suppressive, repressive or advuvant, antibody elemental andchemical compounds to include but not restricted to calcium or magnesiumbarium, strontium, barium, and beryllium, fluorine chlorine bromine,astatine, iodine, oxygen, nitrous oxide or other inhaled or ingested orvascular injected compounds that alter metabolism, PTH 4 hormone orvariations on the hormone or their repressors or stimulators, thyroid 2hormone or their repressors or stimulators.

These methods can be combined with other methods that provide for imagealignment 1 or re-alignment 1, including but not restricted to ComputedTomography (CT), Ultrasound (US), Magnetic Resonance Imaging (MIRI),Thermography, or other imaging and/or positioning techniques.

The methods described above can include but are not restricted to theparathyroid 4, thyroid 2 and can be used for other body parts. Themethods and uses and devices described in this embodiment can be used onliving creatures to include but not restricted to humans.

For purposes of this application, imaging devices and imaging modalitiescan include but are not restricted to external and internal imagingdevices as related to the living creature and can include but are notrestricted to computer tomography (CT), magnetic resonance imaging (MM),positron emission tomography (PET), Nuclear Medicine (NM), single photonemission computed tomography (SPECT) NM, ultrasound and ultrasoundtransducers, x-rays, fluoroscopy, endoscopes, and thermography.

For purposes of this disclosure, nuclear medicine is the application ofradioactive substances to include but not restricted to the diagnosisand treatment of diseases. Radionuclides can be combined with but notrestricted to other elements or compounds, or molecules to formradiopharmaceuticals, which can be used to image the body and itsphysiology. Nuclear Medicine can include the use of radioactivesubstances that can include but are not restricted to elements andcompounds and molecules that can undergo transformation throughprocesses to include but not restricted to radioactive decay andradioactive state changes and can include a nucleus of an unstable atomloses energy by emitting particles of ionizing radiation and isconsidered radioactive. Methods for imaging using radioactive materialsinclude but are not restricted to Positron Emission Tomography (PET),standard nuclear medicine scintigraphy and single photon emissiontomography (SPECT). In medical imaging these can be used alone combinedwith other imaging modalities to include but are not restricted toComputerized Tomography (CT), magnetic resonance imaging (MIRI), routinex-rays, ultrasound and thermography. In some embodiments, a singleisotope can be used but nuclear imaging and assessment can include butis not restricted to utilize and one or multiple isotopes. Isotopes canfor measurement and imaging can include all radioactive isotopes andassociated ligands or pharmaceutical compounds which in some embodimentsinclude but are not restricted to Technecium 99m, Iodine 123, Iodine131, Sestamibi Tc 99m, Flourodeoxyglucose (FDG), Flourine-18, Tc99-HMPAO (hexamethylpropylene amine oxime), thallium-201, xenon-133,indium 111, nitrogen-13, rubidium-82, krypton-81m, and C11-Choline andTc99mMIBI and Tc99m pertechnetate. Dual isotope for parathyroid is mostoften I-123 or Tc99m pertectnetate and Sestamibi tc 99m but can be anycombination of isotopes.

For purposes of this application, temporal variations include but arenot restricted to changes in parameters within a given temporal framethat can include but are not restricted to changes in physical locationor position, changes in radiation including but not restricted to decayand attenuation and increases and decreases in activity, and changes indose administration and uptake and egress and ingress of radioactivityinto and out of the field of view.

For purposes of this application, a non-visual imaging modality orimaging modality other than in the human-visible spectrum refer toimaging modalities capable of detecting wavelengths and frequencies thatare outside the usual human visible wavelengths from about 390 to 700nm, such as frequencies in the vicinity of 430-790 THz, ultraviolet,infrared, x-rays, gamma rays, and radioactive energy. Non-visual imagingmodalities and imaging modalities other than in the human-visiblespectrum may also refer to additional methods for identifying astructure or imaging a structure including but not restricted to othermethods that utilize electromagnetic energy other than light in thehuman visible spectrum, thermography, kinetic energy, ultrasound,lasers, vibrational energy or radioactive energy. In some embodiments,non-visual modalities may additionally or alternatively include thewavelengths within the usual human visible wavelengths features but thewavelengths being interrogated cannot be distinguished normally, readilyor reproducibly by the human eye in a general population and requireadvanced spectral analysis or advanced visual technology for thewavelengths to be distinguished and separated.

LPS can be housed in a space that can be mobile or non-mobile and caninclude man-made and non-man-made structures and can include containerstructure that can include but is not restricted to a room, a container,a box, a helmet, an incubator, a surgical suite, a mobile unit toinclude but not restricted to an ambulance, a transportation vehicle,car, truck, helicopter, airplane, or water structure such as a boat.

The markers or locators of the LPS and GPS system can include but arenot restricted to receive, or transmit and can both transmit and receiveand can include but is not restricted to a transceiver, transponder,MIMO (multiple input, multiple output), service set identifier (SSID),SMS Spam (cell phone spam or short message service spam, infra-redireless, radiofrequency e spam), MISO (multiple input, single output),lasers, ultrasound and other electromagnetic, and mechanical measuringand signaling units.

An object can lie within a body that can include but not restricted tolie beneath the skin, within an orifice to include but not restricted tothe nostrils, the mouth, the orbit, the alimentary canal, the externalauditory canal or the respiratory system and can be embedded, implanted,introduced, surgically inserted, pierced through or placed into anorgan, a hollow viscous, the ectodermal, endodermal and mesodermaltissue and it derivatives.

FIG. 12 is a depiction of a series of arterial waveform changes in ornear the tissue of the organ. In one embodiment the effectiveness ofblood flow can be determined by calculating the area under the curve ofthe waveform. The wavelength can be separated into segments and the areaunder the curve for each of those segments can be calculated. The heightof systolic and diastolic velocities and amplitudes can be measured andcan include but is not restricted to the time needed to reach peakamplitudes and velocities, the time to reach one-half peak or othermeasurements of time to attain measurements to include but notrestricted to flow measurements and velocity or amplitude or duration ofthe waveform or force or blood pressure or calculations to include butnot restricted to resistivity index and peak systolic flow, peakdiastolic flow, aberrations in the waveform, measurement to resistanceto blood flow or pulsatility or pulsatility index or measurements ofacceleration.

By combining these standard flow measurements with the segmentalanalysis of the waveform and the segmental and total area under thesegments of the flow curve and the total waveform or one or morewaveforms a signature can be developed for that waveform that candetermine elements of the blood vessel and the tissue surrounding theblood vessel to include but not restricted to the flow in the vessel,the environment of the distal capillary system, the environment in whichthe blood vessel resides, the health and quality of the blood vessel,the elasticity of the blood vessel, the disease in the blood vessel, thehealth and disease if the tissue fed by and surrounding the blood vesseland the inflow and outflow of the blood vessel including but notrestricted to elements such as the heart and feeding or supplying bloodvessels and elements such as the distal blood vessels or the health ordamage of the tissue and the pressure or resistance in the distaltissue. The segmental and the combined and total segment or averagedanalysis of the individual segments of the waveform and the areacalculations of the waveform and the shape of the waveform provideinsights into blood flow and tissue and biological function that are notprovided by the standard calculation of blood flow such as Resistivityindex and Pulsatility index and Peak Systolic and Diastolic velocitiesthat are the current standards of blood flow analysis.

In one embodiment penile blood flow can be measures within or adjacentto the corpora cavernosum of the penis. In a healthy blood vessel thesegmental area under the systolic component of the curve and thesegmental area of the diastolic component are robust during the earlyerectile phases and the systolic and diastolic areas under the waveformdemonstrate that the blood vessel has large quantities of flow duringboth systole and diastole and indicate good inflow of blood and indicatethat the capillary bed is still engorging and has mild or littleresistance with an internal pressure in the sinusoids that issubdiastolic pressure or less than 60 to 90 mmHg. Later in the erectilecycle the corpora cavernosum engorges and the sinusoids close and thepressure in the corpora cavernosum rises to diastolic levels. Thisresults in the diminishment of inflow of blood during the diastolicphase and the area under the waveform diminishes and will approach zeroinflow and this can be identified early by measuring the area under thediastolic component of the waveform.

As the pressure in the corpora cavernosum continues to increase to thesupra-diastolic pressures, greater than 60 to 90 mmHg the systolicwaveform begins to alter its shape and properties. The peak systolicvelocity can even artificially elevate giving a false sense that thereis increased blood flow but the area under the systolic curve diminishesindicating that in reality the inflow of blood during the systolic phaseis actually diminishing not increasing as might be falsely surmised bythe increasing systolic peak velocities. When the area under thediastolic curve is measured it also indicates diminished flow. When thecorpora cavernosal pressure approaches or equals r even exceeds systolicpressures of between 100 to 140 mmHg the systolic waveform transformsand the area under the systolic curve diminishes. These same waveformarea transformations can be seen in other blood vessel and tissueenvironments of the body to include but not restricted to the brain,kidney, heart, transplanted tissue, the skin, and other bodily organs ortransplanted tissue or prostheses.

The waveform and waveform characteristics can be divided into segmentssuch that the segments can include partial areas within a specificregion of the waveform and these segments can be analyzed at a givenpoint in time and a given temporal frame and then be analyzed in otherpoints in time and other temporal sequences such that the change inspectral value or waveform or area under the curve or blood flow can beassessed and compared as a series or can be compared between one frameand another given frame and that information can be used to determinebut not restricted to changes in blood flow and changes in theresistance around the vessel and in the distal outflow tissue and in theinflow sources. The absolute and the relative values of the quantitativeand qualitative information derived from but not restricted to thewaveform morphology, the waveform area and morphology changes can beanalyzed over a point in time and a temporal sequence and the areaoutside or the waveform and within a given reference area or can includethe inverse of the waveform or its area to yield additional blood flowand tissue characteristics.

These patterns can be applied to but not restricted to arterial flow,venous flow or capillary bed flow. These patterns can be used in thepenis but are not restricted to the penis and can include tissue of thebody that can include but are not restricted to the brain, the skin, totransplanted tissue, to skin flaps, to organs to include but notrestricted to the heart or kidney, or liver. Signatures of thesepatterns of waveform characteristics of these changing patterns can beused to assess both general and specific blood vessel and non-bloodvessel body tissue or a combination of these elements for health anddiminished health or disease.

And can be used to determine tissue and blood vessel health andviability and morphology and disease states.

FIG. 12 depict arterial waveforms 112 with varying degrees of arterialinflow and increasing resistance within the vascular bed/environment.

In FIG. 12a the artery is at maximal inflow and the vascular bed is atminimal resistance. In this example the arterial systolic 100 pressureis 120 mmHg maximally, and diastolic 102 is 80 mmHg maximally and thevascular bed has a minimal pressure of less than 40 mmHg. The total areaunder the curve 112 in systole 100 and diastole 102 is greater than thewaveform 112 area 114 throughout the remainder of the waveform 112 cycleof FIG. 12a through FIG. 12e . In FIG. 12b the arterial flow issubjected to an increase in the vascular capillary and vesselenvironment. The pressure in that environment approaches diastolicpressure 102 at 80 mmHg. In FIG. 12c the arterial flow is subjected toincreasing environmental and capillary resistance and the pressureapproaches supra-diastolic 102 and increasing systolic 100 pressureapproaching 100 mmHg. In FIG. 12d the pressure in the capillary andvascular bed approach systolic pressure of 120 and reverse 105 flow isfound in the diastolic 102 area. In FIG. 12e the pressure issupra-systolic 100 and the arterial systolic 100 flow continues todecrease and the diastolic 102 is zero or negative/reversed (notdepicted). Over the course of the waveform's 112 evolution the area 110under the waveform curves 112 diminishes in response to theapproximation of inflow to the increase in distal arterial outflowwithin the receiving arterial or capillary bed. The midway point 101between systole 100 and diastole 102 can be an arbitrary reference point101.

In FIG. 12f the waveform 112 area can be calculated but the waveform 112can be divided into regions 104,106 of the waveform 112 and waveform 112area 114. The waveform 112 and the waveform 112 area 114 can beinterrogated over time intervals including but not restricted to A1 118and A2 120. The designated region 116 outside of the waveform curve 112but within the designated 118 region or area 114, which can include butis not restricted to a rectangular region of interest 118. In thisembodiment the region 118 is bordered by the initiation of systole 100and the termination of diastole 102.

Enhanced detectability as used in this application includes but is notrestricted to a marker or signal that is able to be differentiated orvisible, or obvious or measurable or evident or demonstrable ornoticeable from the environment in which the marker or signal islocated. For a marker to have enhanced detectability or perceptibilityin the existence of tissue or a body part or implant adjacent or in thevicinity of the marker, in some embodiments, it must include but is notrestricted to a distinguishable and detectable difference relative tothe adjacent or surrounding tissue in the vicinity of the marker in anintensity or precessional spin or relaxation time in MRI, an echopattern or accoustical signature in Ultrasound, an activity level orparticle or energy decay in Nuclear Medicine applications, thermaloutput or temperature in thermography, density in x-ray and CT,mechanical distance or movement in kinetic or mechanical measurements,frequency or amplitude in RF and wavelength in the visible or UV orUltraviolet or electrical or other electromagnetic energy spectra oroutputs. The detectability of a marker or locator is dependent onmultiple factors including but not restricted to the sensitivity for thehuman or non-human receiver to detect differences each of thesemodalities inputs, the precision of the output signal that is sent tothe observing unit or person and the composition of the environment inwhich the marker or locator is being distinguished or detected. Markerranges are relative and can range from differences of less than 1% togreater than 100%. The optimal marker being dependent on the conspicuitybetween the environment and the marer is therefore also dependent on anyartifacts generated around the marker or into the tissue being examined.In one embodiment a small difference of signals of 10 to 50% may beeffective to reduce artifact whereas a larger difference may begin togenerate artifacts as can be the case of acoustical differences intissue in Ultrasound. Large differences of signal can generate artifactsin one modality but not another such a the difference between Air orBone adjacent to brain tissue in some MRI sequences to include but notrestricted to gradient echo or diffusion sequences whereas in CT, solong as the CT is properly calibrated, the difference between air andbone and brain tissue are detectable despite their density differencesthat can be great and even greater than 100% as measured in HounsfieldUnits.

In some embodiments, the first material has a T-1 weighted sequenceresult having an intensity at least as great as fat of the living bodyand the second material has a T-2 weighted sequence result at least 25%as great as that of cerebrospinal fluid of the living body. In someembodiments, the second material has a T-2 weighted sequence result thatis one of 10% as great, 25% as great, 50% as great, 75% as great, 90% asgreat, and 100 percent of that of cerebrospinal fluid of the livingbody. In another embodiment such as CT a difference can include but isnot restricted to a difference of 10 to 50 or greater Hounsfield unitscan be sufficiently detected. In ultrasound the echo pattern oraccoustical signature can be but is not restricted to only 10 to 50%more hyperechoic or hypoechoic relative to the tissue examined oradjacent and in one example air be utilized as a marker where if the airis in the form of a microbubble or nanodrop which can measure but is notrestricted to 10 nm and 10 μm the air particle can be detected whereasif the air is free in an abscess and measures 2 mm it creates anartifact and distorts local tissue. In thermography the temperaturedifferences can include but are not restricted to 1 or less than 1degree. In nuclear medicine the activity can include differences inenergy decay such as gamma of I-131 of 364 KeV and I-123 gamma decay of159 KeV and Technecium or 140 KeV in energy level emitted and as relateto as low a 25 to 500 to 5000 microcuries as related to intensity ofenergy emitted and its relationship to the markers or locatorsbackground. In electromagnetic or wavelength and frequency and amplitudedifferences can be but are not restricted to differences of less than orgreater than 1 to 10% of the portion of the electromagnetic spectrumbeing observed which can include but is not restricted to if frequencyis measured in Hertz (Hz) can include 1 Hz. While the preferredembodiment of the invention has been illustrated and described, as notedabove, many changes can be made without departing from the spirit andscope of the invention. Accordingly, the scope of the invention is notlimited by the disclosure of the preferred embodiment. Instead, theinvention should be determined entirely by reference to the claims thatfollow.

In one embodiment there can be two mobile or non-fixed locators. Thelocators can have send and receive and both send and receivecommunication capacities. Communication in this invention can mean tosend or transmit a signal, receive or accept a signal or can performboth functions and communication can mean to exchange information, amessage, or provide access or send out or receive information or signalsand can also include standard definitions of communication. In oneembodiment one or more locaters referred to as the first locator can beaffixed or be placed on or into the body and the second or more than onesecond locator can be used to locate or identify the first locator. Inone embodiment, the first and second locators can be performed with orseparate from the fixed locators that are used to find the locationwithin the body. In another embodiment the first locator once placed canbe considered or treated as a fixed locator and the second locator canbe mobile and used to find or locate the first locator through variousmethods including but not restricted to visual mapping, imaging, sensorysignals to include but not restricted to auditory, visual or kinetictouch or warmth or vibrational feedback or signals to inform the user ofthe second locator that they are moving closer or further from the firstlocator. In one preferred embodiment, the first locator can be insertedinto a parathyroid gland using a percutaneous needle insertion method.The second locator can be affixed or integrated into but not restrictedto a probe, surgical device, endoscope, fiber optic device, an imagingdevice, or needle such that as the first and second locator approach ordiverge from each other the parameters can be determined as to distanceand orientation from each other. In one embodiment the first locatorthat was inserted in the parathyroid can be measured as a distance 30 mmfrom the second locator, which was paced into the parathyroid underultrasonic guidance and in this embodiment the surgeon can use a probeor scalpel which houses a second locator. As the probe or scalpelapproached the parathyroid containing the first locator a 2-dimensionalor 3-dimensional compass, altimeter, accelerometer or axis can informthe user that the probe or scalpel with the second locator isapproaching or diverging from the first locator. Feedback signals orcorrection can be used to direct the surgeon to the parathyroidcontaining the first locator. This technique can be used for but notrestricted to other body tissue and for implants, which can bebiological or non-biological or organic or non-organic in nature.Locators or sensors can be or can include or incorporate devices toinclude compass, axis adjustment, accelerometer and altimeter.

Exemplary Embodiments

1. A method for imaging comprising:

receiving, by a computer system, a plurality of image frames, theplurality of image frames representing received nuclear radiation from aregion of interest within a living body at a series of time points;

receiving, by the computer system, for each frame of at least a portionof the plurality of image frames, a secondary measurement of the livingbody corresponding to the each frame; and

generating, by the computer system, a plurality of adjusted frames basedon the plurality of image frames by transforming at least a portion ofthe plurality of image frames according to the secondary measurements ofthe living body corresponding to the at least a portion of the pluralityof image frames.

2. The method of embodiment 1, further comprising:

evaluating, by the computer system, temporal variation among theplurality of adjusted frames;

generating, by the computer system, an enhanced frame corresponding toan original frame of the plurality of image frames according to theevaluation of temporal variation of the plurality of adjusted frames,the enhanced frame having an enhanced representation of one or moretarget features relative to the one or more target features in theoriginal frame; and

transmitting, by the computer system, the enhanced frame for display

3. The method of embodiment 2, wherein generating, by the computersystem, the enhanced frame according to the evaluation of temporalvariation among the plurality of adjusted frames further comprises:

adjusting in a first manner one or more first portions of the enhancedframe having a first temporal variation pattern in the plurality ofadjusted frames; and

adjusting in a second manner one or more second portions of the enhancedframe having a second temporal variation pattern in the plurality ofadjusted frames.

4. The method of embodiment 3, wherein the one or more first portionscorrespond to parathyroid glands of the living body and the one or moresecond portions correspond to a thyroid gland of the living body.

5. The method of embodiment 1, wherein transforming the at least aportion of the plurality of image frames according to the secondarymeasurements further comprises, for each frame of the at least a portionof the plurality of image frames:

identifying one or more first reference measurements from the secondarymeasurement corresponding to the each frame;

identifying one or more second reference measurements from the secondarymeasurement corresponding to a frame other than the each frame in theplurality of image frames; and

generating the adjusted frame of the plurality of adjusted framescorresponding to the each frame based on the first and second referencemeasurements.

6. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving one or more position measurements from one or more globalpositioning system receivers affixed to the living body.

7. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving one or more position measurements from one or more localpositioning system receivers affixed to the living body.

8. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving an image from a camera having the living body in a field ofview thereof.

9. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving a thermographic image from a thermographic camera having theliving body in a field of view thereof.

10. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving measurements of translucence of the living body in apredetermined wavelength range.

11. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving measurements of the living body from a mechanical measuringmeans.

12. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving measurements of the living body from a magnetic resonanceimaging system.

13. The method of embodiment 1, wherein receiving, by the computersystem, for the each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises receiving measurements of the livingbody from an ultrasound imaging system.

14. The method of embodiment 1, wherein receiving, by the computersystem, for each frame of the at least a portion of the plurality ofimage frames, the secondary measurement of the living body correspondingto the each frame further comprises:

receiving measurements of the living body from at least one of an X-rayimaging system and a computed tomography imaging system.

15. The method of embodiment 1, wherein the received radiation from theregion of interest is in response to administration of Tc99m-estamibi tothe living body.

16. The method of embodiment 1, wherein the received radiation from theregion of interest is in response to administration of a substancesuitable for at least one of positron emission tomography andsingle-photon emission computed tomography.

17. A system for imaging comprising:

a radiation sensing system operable to detect radiation from a livingbody;

a secondary measurement system operable to detect a position of theliving body; and

a computer system operably coupled to the radiation sensing system andthe secondary measurement system, the computer system comprising one ormore processors and one or more memory devices operably coupled to theone or more processors, the one or more memory devices storingexecutable and operational data effective to cause the one or moreprocessors to

receive a plurality of image frames from the radiation sensing system,

receive, for each frame of at least a portion of the plurality of imageframes, a secondary measurement of the living body corresponding to theeach frame from the secondary measurement system, and

generate a plurality of adjusted frames based on the plurality of imageframes by transforming at least a portion of the plurality of imageframes according to the secondary measurements of the living bodycorresponding to the at least a portion of the plurality of imageframes.

18. The system of embodiment 17, wherein the executable and operationaldata are further effective to cause the one or more processors to:

evaluate temporal variation among the plurality of adjusted frames;

generate an enhanced frame corresponding to an original frame of theplurality of image frames according to the evaluation of temporalvariation of the plurality of adjusted frames, the enhanced frame havingan enhanced representation of one or more target features relative tothe one or more target features in the original frame; and

transmit the enhanced frame for display

19. The system of embodiment 18, wherein the executable and operationaldata are further effective to cause the one or more processors togenerate the enhanced frame according to the evaluation of temporalvariation among the plurality of adjusted frames by performing at leastone of:

adjusting in a first manner one or more first portions of the enhancedframe having a first temporal variation pattern in the plurality ofadjusted frames; and

adjusting in a second manner one or more second portions of the enhancedframe having a second temporal variation pattern in the plurality ofadjusted frames.

20. The system of embodiment 19, wherein the one or more first portionscorrespond to parathyroid glands of the living body and the one or moresecond portions correspond to a thyroid gland of the living body.

21. The system of embodiment 17, wherein the executable and operationaldata are further effective to cause the one or more processors totransform the at least a portion of the plurality of image framesaccording to the secondary measurements by, for each frame of the atleast a portion of the plurality of image frames:

identifying one or more first reference measurements from the secondarymeasurement corresponding to the each frame;

identifying one or more second reference measurements from the secondarymeasurement corresponding to a frame in the plurality of image framesother than the each frame; and

generating the adjusted frame of the plurality of adjusted framescorresponding to the each frame based on the first and second referencemeasurements.

22. The system of embodiment 17, wherein the secondary measurementsystem is one or more of

global positioning system receivers coupled to the living body;

one or more local positioning system receivers affixed to the livingbody;

a thermographic camera having the living body in a field of viewthereof;

a magnetic resonance imaging system;

an X-ray imaging system;

a computed tomography system;

a positron emission tomography system;

a single photon emission tomography system;

an ultrasound imaging system; and

a mechanical measuring means.

23. A method for imaging comprising:

receiving, by a computer system, a plurality of image frames, theplurality of image frames representing received radiation from a regionof interest within a living body at a series of time points;

evaluating, by the computer system, temporal variation among theplurality of image frames;

generating, by the computer system, an enhanced frame according to theevaluation of temporal variation by modifying an original frame of theplurality of image frames effective to enhance visibility of one or moretarget features of the one or more features in the enhanced frame; and

transmitting, by the computer system, the enhanced frame for display

24. The method of embodiment 23, wherein modifying the original frameeffective to enhance visibility of one or more target features furthercomprises:

adjusting in a first manner one or more first portions of the originalframe having a first temporal variation pattern relative to a referenceintensity; and

adjusting in a second manner one or more second portions of the originalframe having a second temporal variation pattern relative to thereference intensity.

25. The method of embodiment 24, wherein adjusting the one or more firstportions in the first manner and adjusting the one or more secondportions in the second manner comprises applying a temporal filter tothe plurality of image frames.

26. The method of embodiment 25, wherein the temporal filter includesone or more of a linear filter, non-linear filter, Gaussian filter, andexponential curve filter.

27. The method of embodiment 24, wherein the one or more first portionscorrespond to parathyroid glands of the living body and the one or moresecond portions correspond to a thyroid gland of the living body.

28. The method of embodiment 23, wherein generating, by the computersystem, the enhanced frame according to the evaluation of temporalvariation further comprises:

modifying the original frame according to application of a mathematicalmodel to the plurality of image frames.

29. The method of embodiment 23, wherein generating, by the computersystem, the enhanced frame according to the evaluation of temporalvariation further comprises:

modifying the original frame according to temporal variation of areference feature in the plurality of image frames.

30. The method of embodiment 29, wherein the reference feature comprisesa representation of radiation emitted by an artificial structure affixedto the living body.

31. The method of embodiment 30, wherein the artificial structure has aknown decay rate and wherein modifying the original frame according totemporal variation of the reference feature of the one or more featuresfurther comprises:

correcting measured activity for one or more portions of the originalframe according to measured activity for the artificial structure andthe known decay rate.

32. The method of embodiment 23, further comprising identifying, by thecomputer system, a representation of a thyroid of the living body in theplurality of image frames by identifying in the plurality of imageframes portions having an initial increase in activity relative toreference activity apparent in the plurality of image frames followed bya decrease in activity meeting a threshold condition with respect to thereference activity; and

wherein generating, by the computer system, the enhanced frame accordingto the evaluation of temporal variation comprises altering therepresentation of the thyroid in the enhanced frame.

33. The method of embodiment 23, further comprising adjusting one ormore of the plurality of image frames to compensate for movement of theliving body across the series of time points.

34. The method of embodiment 33, wherein adjusting one or more adjustedframes of the plurality of image frames to compensate for movement ofthe living body across the series of time points further comprises:

identifying, by the computer system, a location of one or more featuresin the plurality of image frames; and

adjusting the one or more adjusted frames according to the identifiedlocations of the one or more features in the plurality of image frames.

35. A method for imaging comprising:

administering a radioisotope to a living body;

receiving, by a computer system from a detector, a plurality of imageframes, the plurality of image frames representing received radiationfrom a region of interest within the living body at a series of timepoints subsequent to administration of the radioisotope;

evaluating, by the computer system, temporal variation of the pluralityof image frames;

generating, by the computer system, an enhanced frame according to theevaluation of the temporal variation effective to enhance conspicuity ofone or more representations of one or more parathyroid glands of theliving body in the enhanced frame; and

transmitting, by the computer system, the enhanced frame for display;and

36. The method of embodiment 35, wherein evaluating temporal variationof the plurality of image frames further comprises:

identifying, by the computer system, representations of a thyroid glandin the plurality of image frames according to temporal variation of therepresentations of the thyroid gland in the plurality of image frames;and

wherein generating the enhanced frame further comprises adjusting arepresentation of the thyroid gland in the enhanced frame effective toenhance the conspicuity of the one or more representations of the one ormore parathyroid glands.

37. The method of embodiment 36, wherein identifying, by the computersystem, the representations of the thyroid gland in the plurality ofimage frames according to the temporal variation of the representationsof the thyroid gland in the plurality of image frames further comprisesidentifying in the plurality of image frames an initial increase inactivity of the representations of the thyroid gland relative toreference activity apparent in the plurality of image frames followed bya decrease in activity meeting a threshold condition.

38. The method of embodiment 35, further comprising identifying the oneor more representations of the one or more parathyroid glands in theplurality of image frames according to temporal variation of the one ormore representations of the one or more parathyroid glands in theplurality of image frames.

39. The method of embodiment 38, wherein generating the enhanced framefurther comprises adjusting the representations of the one or moreparathyroid glands in the selected frame to enhance conspicuity of therepresentations of the one or more parathyroid glands.

40. The method of embodiment 38, wherein identifying the representationof the one or more parathyroid glands in the plurality of image framesaccording to the temporal variation of the representations of the one ormore parathyroid glands in the plurality of image frames furthercomprises:

identifying the representations of the one or more parathyroid glandsaccording to increasing activity of the representations one or moreparathyroid glands relative to reference activity represented in theplurality of image frames.

41. The method of embodiment 35, further comprising adjusting one ormore of the plurality of image frames to compensate for movement of theliving body across the series of time points.

42. The method of embodiment 35, further comprising:

identifying, by the computer system, representations of one or moreother organs exclusive of the thyroid gland of the living body; and

adjusting one or more of the plurality of image frames according tolocations of the representations of the one or more other organs tocompensate for movement of the living body across the series of timepoints.

43. The method of embodiment 35, wherein the radioisotope is theradioisotope is Tc99m-sestamibi.

44. The method of embodiment 35, further comprising:

identifying, by the computer system, the one or more representations ofthe one or more parathyroid glands in the enhanced frame;

identifying, by the computer system, a representation of the thyroidgland in the enhanced frame;

evaluating, by the computer system, one or more locations of the one ormore representations of the one or more parathyroid glands relative tothe representation of the thyroid in the enhanced frame; and

characterizing, by the computer system, health of the one or moreparathyroid glands according to the evaluation of the locations of theone or more parathyroid gland.

45. The method of embodiment 44, wherein evaluating the one or morelocations of the one or more representations of the one or moreparathyroid glands further comprises evaluating at least one of:

asymmetry of the one or more locations of the one or morerepresentations of the one or more parathyroid glands relative to thethyroid;

atypical positioning of the one or more locations of the one or morerepresentations of the one or more parathyroid glands relative to thethyroid; and

eccentric positioning of the one or more locations of the one or morerepresentations of the one or more parathyroid glands relative to thethyroid;

46. A method for imaging comprising:

administering a radioisotope to a living body;

receiving, by a computer system from a detector, an original frame, theoriginal image representing received radiation from a region of interestwithin the living body subsequent to administration of the radioisotope;

administering a first treatment to the living body subsequent toadministering the radioisotope, the first treatment effective to reduceactivity in one or more parathyroid glands of the living body;

receiving, by the computer system from the detector, a confirmationframe, the confirmation frame representing received radiation from theregion of interest within the living body subsequent to administeringthe first treatment;

comparing the confirmation frame to the original frame; and

identifying as one or more representations of the one or moreparathyroid glands those portions of the original frame that have highapparent activity and for which corresponding portions in theconfirmation frame have reduced apparent activity.

47. The method of embodiment 46, wherein the first treatment is at leastone of non-radioactively labeled sestamibi, calcium, a calcium channelblocker, and an agent that alters the sensitivity of sensing receptorsin the parathyroid.

48. A method for imaging comprising:

administering a first treatment to a living body, the first treatmentoperable to alter functioning of a first organ of the living body; and

generating an image of at least a portion of the living body includingthe first organ using a first imaging modality;

wherein the first treatment is effective to enhance conspicuity of atarget portion of the living body due to the altering of the functioningof the first organ.

49. The method of embodiment 48, wherein the target portion is a secondorgan of the living body.

50. The method of embodiment 48, wherein the target portion is the firstorgan.

51. The method of embodiment 48, wherein the first organ is aparathyroid gland of the living body.

52. The method of embodiment 51, wherein the first treatment iseffective to increase blood flow in the parathyroid gland.

53. The method of embodiment 51, wherein the first treatment is at leastone of hydrochlorothiazide, calcium, calcium channel blocker, aninorganic phosphate, and an agent that alters the sensitivity of thesensing receptors in the parathyroid.

54. The method of embodiment 48, wherein the organ is a thyroid gland ofthe living body and the target portion is at least one parathyroid glandof the living body.

55. The method of embodiment 54, wherein the first treatment iseffective to reduce blood flow to the thyroid gland.

56. The method of embodiment 55, wherein the first treatment is at leastone of propylthiouracil, methimazole (Tapazole), thiourea, thiouracil,and a derivative of at least one of propylthiouracil, methimazole(Tapazole), thiourea, iodine, and thiouracil

57. The method of embodiment 48, further comprising administering afirst substance to the living body, the first substance detectableaccording to the first imaging modality;

wherein the first treatment affects uptake by the first organ of thefirst substance.

58. The method of embodiment 57, wherein the first organ is a thyroidgland of the body, the first substance is Tc-99 Sestamibi, and firsttreatment is at least one of:

a thyroid agent including at least one of propylthiouracil, methimazole(Tapazole), thiourea, thiouracil, iodine, a thyroid 2 stimulatinghormone (TSH), a thyroid 2 releasing hormone (TRH), a TSH blockingagent, a TRH blocking agent; and

and a derivative of the thyroid agent.

59. The method of embodiment 48, further comprising:

receiving, by a computer system, a plurality of first image frames, theplurality of first image frames representing received nuclear radiationfrom a region of interest within the living body at a series of timepoints;

receiving, by the computer system, for each frame of at least a portionof the plurality of image frames, a plurality of second image frames ofthe living body corresponding to the each frame, the second image framesobtained using the first imaging modality; and

generating, by the computer system, a plurality of adjusted frames basedon the plurality of first image frames by transforming at least aportion of the plurality of first image frames according to theplurality of second image frames corresponding to the at least a portionof the plurality of first image frames.

60. The method of embodiment 59, further comprising:

evaluating, by the computer system, temporal variation among theplurality of adjusted frames;

generating, by the computer system, an enhanced frame corresponding toan original frame of the plurality of image frames according to theevaluation of temporal variation of the plurality of adjusted frames,the enhanced frame having an enhanced representation of one or moretarget features relative to the one or more target features in theoriginal frame; and

transmitting, by the computer system, the enhanced frame for display

61. The method of embodiment 60, wherein generating, by the computersystem, the enhanced frame according to the evaluation of temporalvariation among the plurality of adjusted frames further comprises:

adjusting in a first manner one or more first portions of the enhancedframe having a first temporal activity pattern in the plurality ofadjusted frames; and

attenuating in a second manner one or more second portions of theenhanced frame having a second temporal activity pattern in theplurality of adjusted frames.

62. The method of embodiment 48, wherein the first treatment iseffective to affect calcium uptake by the first organ.

63. The method of embodiment 48, wherein the first treatment is one ofadding and withdrawing energy from the organ.

64. A method for imaging comprising:

administering a first treatment to a living body, the first treatmentoperable to alter functioning of at least one of a thyroid gland and aparathyroid gland of the living body; and

generating an image of at least a portion of the living body includingthe parathyroid gland using a first imaging modality;

wherein the first substance is effective to enhance conspicuity of theparathyroid gland.

65. The method of embodiment 64, wherein the first treatment iseffective to affect at least one of blood flow and uptake of a firstsubstance by at least one of the thyroid gland and the parathyroidgland.

66. The method of embodiment 65, wherein the first substance is Tc-99Sestamibi.

67. The method of embodiment 66, wherein the first treatment iseffective to at least one of increase uptake of Tc-99 Sestamibi by theparathyroid gland and decrease uptake of Tc-99 Sestamibi by the thyroidgland.

68. A marker for imaging applications, the marker comprising:

a flexible structure conformable to a part of a living body, theflexible structure formed of a gelatinous elastomer; and

wherein the flexible structure further includes one or more materialseffective to provide enhanced detectability in a plurality of imagingmodalities in addition to the human visible spectrum.

69. The marker of embodiment 68, wherein at least one surface of theflexible structure at least one of is tackified and has an adhesivematerial secured thereto.

70. The marker of embodiment 68, wherein the flexible structure issecured to a rigid frame, the frame having at least one surfaceconfigured to conform to a portion of the living body.

71. The marker of embodiment 68, wherein the flexible structure issecured to a wearable item configured to fit over a portion of theliving body.

72. The marker of embodiment 68, wherein the flexible structure securesto a portion of a hook-and-loop fastening system.

73. The marker of embodiment 68, wherein the one or more materials eachhave a signature in the plurality of imaging modalities that isdistinguishable from tissue adjacent the flexible structure in theliving body.

74. The marker of embodiment 68, wherein the plurality of imagingmodalities include at least two of:

-   -   ultrasound;    -   x-rays;    -   computer tomography;    -   magnetic resonance imaging; and    -   nuclear medicine imaging.

75. The marker of embodiment 68, wherein at least one of the one or morematerials is substantially homogeneously incorporated into the flexiblestructure.

76. The marker of embodiment 68, wherein the flexible structure definesa cavity and at least one of the one or more materials is positionedwithin the cavity.

77. The marker of embodiment 68, wherein the flexible structure definesa cavity and an electronic device is positioned within the cavity.

78. The marker of embodiment 77, wherein the electronic devicecomprises:

at least one sensor operable to detect at least one of an environmentalfactor and a biological process of the living body; and

a transmitter coupled to the sensor and operable to transmit arepresentation of at least one output of the at least one sensor.

79. The marker of embodiment 68, wherein the marker includes a radiationexposure sensor.

80. The marker of embodiment 68, wherein the flexible structure has anon-natural perimeter shape.

81. The marker of embodiment 80, wherein the non-natural perimeter shapeis at least one of a circle, triangle, square, and ellipse.

82. The marker of embodiment 68, wherein the flexible structure definesan annular shape having a void providing accessibility to skin of theliving body to which the marker is secured.

83. The marker of embodiment 68, wherein the gelatinous elastomer isresiliently deformable.

84. The marker of embodiment 68, wherein the plurality of imagingmodalities include at least two magnetic resonance imaging sequencesselected from: T-1 spin echo, T-2 spin echo, gradient echo, turbo spinecho, spectroscopy and inversion recovery, fluid attenuated inversionrecovery, and short T-1 inversion recovery.

85. A marker for imaging applications, the marker comprising:

a flexible structure conformable to a part of a living body;

a first material incorporated into the flexible structure, the firstmaterial being at least one of a hydrophilic and a water-like materialat least one of a lipophilic material, lipid, oil, and fat-likematerial; and

a second material incorporated into the flexible structure, the secondmaterial being at least one of a hydrophilic and a water-like material.

86. The marker of embodiment 85, wherein the first and second materialsare mixed together.

87. The marker of embodiment 86, wherein the first and second materialsare homogeneously mixed.

88. The marker of embodiment 85, wherein the flexible structure includesa gelatinous elastomer.

89. The marker of embodiment 88, wherein the flexible structure isresiliently deformable.

90. The marker of embodiment 88, wherein the gelatinous elastomerincorporates the first material and second material in a blockcopolymer.

91. The marker of embodiment 85, wherein the first material has a T-1weighted sequence result having an intensity at least as great as fat ofthe living body and the second material has a T-2 weighted sequenceresult at least 25% as great as that of cerebrospinal fluid of theliving body.

92. The marker of embodiment 85, wherein the flexible structure hasenhanced detectability in an imaging modality other than the humanvisible spectrum, the imaging modality including at least one of:

-   -   ultrasound;    -   x-rays;    -   computer tomography; and    -   nuclear medicine imaging.

93. The marker of embodiment 85, wherein the flexible structure has anon-natural perimeter shape.

94. The marker of embodiment 85, wherein the non-natural perimeter shapeis at least one of a circle, triangle, square, and ellipse.

95. A method for diagnosing a condition comprising:

-   -   applying one or more markers to a living body, each of the one        or more markers having a different marker signature in a first        imaging modality;    -   generating an image of at least a portion of the living body        including the one or more markers using the first imaging        modality;    -   comparing a tissue signature of a representation of tissue in        the living body in the image to the marker signatures of a        representation of the one or more markers in the image; and    -   diagnosing a condition of the tissue according to the        comparison.

96. The method of embodiment 95, wherein the steps of comparing anddiagnosing are performed by a computer system.

97. The method of embodiment 95, wherein the one or more markers includea plurality of markers each having a different combination of T-1weighted compounds and T-2 weighted compounds.

98. The method of embodiment 95, wherein diagnosing the condition of thetissue according to the comparison comprises determining at least one ofbone marrow composition, extent of fatty liver condition, extent offibrotic liver condition, extent of osteoporosis, presence of diabetes,degree of pancreatic fatty replacement, presence of adenomas, presenceof tumors, presence of aggressive tumors, body fat calculations, andpresence of metabolic replacement diseases.

99. The method of embodiment 95, wherein the one or more markers includea radiation exposure sensor.

100. A method for imaging comprising:

receiving, by a computer system, a plurality of image frames, theplurality of image frames representing received radiation from a regionof interest within a living body at a series of time points;

identifying, by the computer system, representations of one or moreorgans and locations thereof in the plurality of image frames;

generating, by the computer system, a plurality of adjusted frames basedon the image frames wherein one or more of the adjusted frames have beentransformed relative to corresponding image frames of the plurality ofimage frames according to the locations of the representations of theone or more organs in the corresponding image frames.

101. The method of embodiment 100, further comprising:

evaluating, by the computer system, temporal variation among theplurality of adjusted frames;

generating, by the computer system, an enhanced frame corresponding toan original frame of the plurality of image frames according to theevaluation of temporal variation of the plurality of adjusted frames,the enhanced frame having an enhanced representation of one or moretarget features relative to the one or more target features in theoriginal frame; and

transmitting, by the computer system, the enhanced frame for display

102. The method of embodiment 101, wherein generating, by the computersystem, the enhanced frame according to the evaluation of temporalvariation among the plurality of adjusted frames further comprises:

adjusting in a first manner one or more first portions of the enhancedframe having a first temporal variation pattern in the plurality ofadjusted frames; and

adjusting in a second manner one or more second portions of the enhancedframe having a second temporal variation pattern in the plurality ofadjusted frames.

103. The method of embodiment 102, wherein the one or more firstportions correspond to parathyroid glands of the living body and the oneor more second portions correspond to a thyroid gland of the livingbody.

104. The method of embodiment 100, wherein generating, by the computersystem, the plurality of adjusted frames based on the plurality of imageframes further comprises:

identifying expected three-dimensional locations of the one or moreorgans based on the plurality of image frames; and

calculating two-dimensional locations for the one or more organs in theplurality of adjusted image frames based on the expectedthree-dimensional locations.

105. The method of embodiment 100, wherein, wherein generating, by thecomputer system, the plurality of adjusted frames based on the pluralityof image frames further comprises, for each frame of at least a portionof the plurality of image frames:

identifying first locations of the representations of the one or moreorgans in the each frame;

identifying second locations of the representations of the one or moreorgans in a frame other than the each frame in the plurality of imageframes; and

generating the adjusted frame of the plurality of adjusted framescorresponding to the each frame according to a transformation based onthe first locations and the second locations.

106. The method of embodiment 100, wherein the one or more organsperform uptake of a radioisotope.

107. The method of embodiment 100, wherein the one or more organs have afixed location within the living body.

108. The method of embodiment 100, wherein the one or more organsinclude one or more of the salivary glands, nasal mucosa, heart, liver,and spleen of the living body.

109. The method of embodiment 100, wherein the received radiation fromthe region of interest is in response to administration ofTc99m-sestamibi to the living body.

110. A method for imaging comprising:

administering a radioisotope to a living body;

affixing one or more radioactive markers relative to the living body;

receiving, by a computer system, a plurality of image frames, theplurality of image frames representing received radiation from theradioactive markers and from within the living body at a series of timepoints;

identifying, by the computer system, one or more reference features andthe locations thereof in the plurality of image frames, the one or morereference features corresponding to the radioactive markers;

generating, by the computer system, a plurality of adjusted frames basedon the image frames wherein one or more of the adjusted frames have beentransformed relative to corresponding image frames of the plurality ofimage frames according to the locations of the one or more referencefeatures in the corresponding image frames.

111. The method of embodiment 110, further comprising identifying, bythe computer system, representations of one or more organs and locationsthereof in the plurality of image frames;

wherein generating the plurality of adjusted frames based on the imageframes further comprises generating the plurality of adjusted frames bytransforming corresponding image frames of the plurality of image framesbased on both the locations of the reference features and the locationsof the representations of the one or more organs in the correspondingimage frames.

112. The method of embodiment 111, wherein the one or more organsinclude one or more of the salivary glands, nasal mucosa, heart, liver,and spleen of the living body.

113. The method of embodiment 110, wherein, wherein generating, by thecomputer system, the plurality of adjusted frames based on the pluralityof image frames further comprises, for each frame of at least a portionof the plurality of image frames:

identifying first locations of the representations of the one or moreorgans in the each frame;

identifying second locations of the representations of the one or moreorgans in a frame other than the each frame in the plurality of imageframes; and

generating the adjusted frame of the plurality of adjusted framescorresponding to the each frame according to a transformation based onthe first locations and the second locations.

114. The method of embodiment 110, further comprising:

evaluating, by the computer system, temporal variation among theplurality of adjusted frames;

generating, by the computer system, an enhanced frame corresponding toan original frame of the plurality of image frames according to theevaluation of temporal variation of the plurality of adjusted frames,the enhanced frame having an enhanced representation of one or moretarget features relative to the one or more target features in theoriginal frame; and

transmitting, by the computer system, the enhanced frame for display

115. The method of embodiment 114 wherein generating, by the computersystem, the enhanced frame according to the evaluation of temporalvariation among the plurality of adjusted frames further comprises:

adjusting in a first manner one or more first portions of the enhancedframe having a first temporal variation pattern in the plurality ofadjusted frames; and

adjusting in a second manner one or more second portions of the enhancedframe having a second temporal variation pattern in the plurality ofadjusted frames.

116. The method of embodiment 115, wherein the one or more firstportions correspond to parathyroid glands of the living body and the oneor more second portions correspond to a thyroid gland of the livingbody.

117. The method of embodiment 110, wherein affixing one or moreradioactive markers relative to the living body comprises affixing theone or more radioactive markers to skin of the living body.

118. The method of embodiment 110, wherein affixing one or moreradioactive markers relative to the living body comprises placing theradioactive markers internal to the living body.

119. The method of embodiment 109, wherein the radioisotope isTc99m-sestamibi.

While the invention has been particularly shown and described asreferenced to the embodiments thereof, those skilled in the art willunderstand that the foregoing and other changes in form and detail maybe made therein without departing from the spirit and scope of theinvention.

1. A local positioning system (LPS) comprising: at least three localposition tracking devices, each local position tracking device furthercomprising: a clock synchronized to the clock in each of the other localposition tracking devices; a transmitter transmitting messages over timesynchronized to the clock, each of the messages comprising a time thatthe message was transmitted and known initial positional information ofthe transmitting local position tracking device with respect to each ofthe local position tracking devices; and a receiver receiving themessages over time from the other local position tracking devices; animage visualization representation of a living body as represented overtime and comprising a plurality of time-sequential frames correspondingwith the locations of each of the local position tracking devices overtime; an output component; and a processor operatively coupled as partof at least one of the local position tracking devices, wherein theprocessor is configured to create and generate a temporally-changingcoordinate map over time based on, for each of the messages, the timethat the message was transmitted, a time that the message was receivedand the known initial positional information, the processor is furtherconfigured to combine the plurality of the time-sequential frames of theimage visualization representation at the same time as the creation andgeneration of the temporally-changing coordinate map into a plurality ofenhanced frames, and the processor is still further configured tocontinually output the enhanced frames to the output component.
 2. AnLPS in accordance with claim 1, wherein the processor is still furtherconfigured to perform at least one of assessing, analyzing, comparing,calculating, computing, and communicating one or more of the imagevisualization representation, the temporally-changing coordinate map,and the enhanced frames.
 3. An LPS in accordance with claim 1, furthercomprising: a sensor distributed in a different location about theliving body that detects a physiological parameter over time pertainingto the living body, the sensor further comprising: a clock synchronizedto the clock in each of the local position tracking devices; atransmitter transmitting messages over time synchronized to the clock,each such message comprising the physiological parameter detected by thesensor, wherein the processor is yet further configured to identifychanges in the physiological parameters detected by sensors over timesimultaneous to the creation and generation of the temporally-changingcoordinate map, and the processor is still further configured tocontinually output the identified changes in the physiologicalparameters over time to the output component.
 4. An LPS in accordancewith claim 3, further comprising: a physical marker comprised withineach of the sensors.
 5. An LPS in accordance with claim 3, wherein theprocessor is still further configured to perform at least one ofassessing, analyzing, comparing, calculating, computing, andcommunicating one or more of the image visualization representation, thetemporally-changing coordinate map, the enhanced frames, and thephysiological parameter detected by the sensor.
 6. An LPS in accordancewith claim 3, further comprising: a computer comprising a furtherprocessor, the computer operatively interfacing with the outputcomponent, wherein the further processor is configured to operate on oneor more of the enhanced frames and the physiological parameter detectedby the sensor.
 7. An LPS in accordance with claim 6, the processor isstill further configured to output at least one of the imagevisualization representation and the temporally-changing coordinate map,wherein the further processor is further configured to operate on one ormore of the image visualization representation, the temporally-changingcoordinate map, the enhanced frames, and the physiological parameterdetected by the sensor.
 8. An LPS in accordance with claim 7, whereinthe further processor is still further configured to perform at leastone of assessing, analyzing, comparing, calculating, computing, andcommunicating one or more of the image visualization representation, thetemporally-changing coordinate map, and the enhanced frames, and thephysiological parameter detected by the sensor.
 9. An LPS in accordancewith claim 1, wherein at least two of the local position trackingdevices are positioned on structure of the living body.
 10. An LPS inaccordance with claim 9, further comprising: at least one of the localposition tracking devices monitoring a position of the structurerelative to the distances of the at least two local position trackingdevices from each of the other local position tracking devicessubsequent to the positioning on the structure based on the positionalcoordinates of the at least two local position tracking devices withinthe temporally-changing coordinate map.
 11. An LPS in accordance withclaim 1, further comprising: a computer comprising a further processor,the computer operatively interfacing with the output component, whereinthe further processor is configured to operate on the enhanced frames.12. An LPS in accordance with claim 11, the processor is still furtherconfigured to output at least one of the image visualizationrepresentation and the temporally-changing coordinate map, wherein thefurther processor is further configured to operate on one or more of theimage visualization representation, the temporally-changing coordinatemap, and the enhanced frames.
 13. An LPS in accordance with claim 12,wherein the further processor is still further configured to perform atleast one of assessing, analyzing, comparing, calculating, computing,and communicating one or more of the image visualization representation,the temporally-changing coordinate map, and the enhanced frames.
 14. AnLPS in accordance with claim 1, further comprising: a robotic mechanismoperatively interfacing with the output component and configured tooperate based on analysis of the enhanced frames as continually providedthrough the output component.
 15. An LPS in accordance with claim 14,wherein the robotic mechanism is comprised with at least one of thelocal position tracking devices and further comprises a medicalimplement operatively controllable by the computer based upon thedistance of the at least one local position tracking device from each ofthe other local position tracking devices.
 16. An LPS in accordance withclaim 11, further comprising: a communications device operativelyinterfacing with the output component and configured to communicate theenhanced frames as continually provided through the output component.17. An LPS in accordance with claim 1, wherein the output componentcomprises a display.
 18. An LPS in accordance with claim 1, wherein theprocessor is yet further configured to combine the plurality of thetime-sequential frames of the image visualization representation as of atime occurring before the creation and generation of thetemporally-changing coordinate map into a plurality of enhanced frames.19. An LPS in accordance with claim 1, wherein the processor is yetfurther configured to combine the plurality of the time-sequentialframes of the image visualization representation as of a time occurringafter the creation and generation of the temporally-changing coordinatemap into a plurality of enhanced frames.
 20. An LPS in accordance withclaim 1, further comprising: a barrier physically surrounding the livingbody, the at least one local position tracking device and the pluralityof local position tracking devices and defining an isolated space thatis shielded from electromagnetic energy interference.
 21. An LPS inaccordance with claim 20, wherein the barrier comprises a faraday cage.22. An LPS in accordance with claim 1, further comprising: the outputcomponent comprising the temporally-changing coordinate map ascontinually output by the at least one local position tracking deviceand the image visualization representation of the living body with thepositional coordinates of the local position tracking devices marked.23. An LPS in accordance with claim 22, further comprising: a non-visualmedical imaging modality that operates in a spectrum falling outside ofwavelengths and frequencies visible to a human eye; and thetime-sequential frames further comprising the image visualizationrepresentation of the living body as detected by the non-visual medicalimaging modality.
 24. An LPS in accordance with claim 22, furthercomprising: a visual medical imaging modality that operates in aspectrum falling within wavelengths and frequencies visible to a humaneye; and the time-sequential frames further comprising the imagevisualization representation of the living body as detected by thevisual medical imaging modality.
 25. An LPS in accordance with claim 1,at least one of the local position tracking devices further comprisingat least one of: a prosthesis suitable for engagement with, into, oronto the living body; medical instrumentation operable upon the livingbody; and medical hardware used within, upon, against, or around theliving body.
 26. A local positioning ultrasound system, comprising: atleast three local position tracking devices, each local positiontracking device further comprising: a clock synchronized to the clock ineach of the other local position tracking devices; a transmittertransmitting messages over time synchronized to the clock, each of themessages comprising a time that the message was transmitted and knowninitial positional information of the transmitting local positiontracking device with respect to each of the other local positiontracking devices; and a receiver receiving the messages over time fromthe other local position tracking devices; an ultrasound imagingmodality comprising an ultrasound probe and continually providing animage visualization representation of the living body as representedover time and comprising a plurality of time-sequential framescorresponding with the locations of each of the local position trackingdevices over time, at least one of the local position tracking devicesbeing comprised on an aspect of the ultrasound probe; an outputcomponent; and a processor operatively coupled as part of at least oneof the local position tracking devices, wherein the processor isconfigured to create and generate a temporally-changing coordinate mapover time based on, for each of the messages, the time that the messagewas transmitted, a time that the message was received and the knowninitial positional information, the processor is further configured tocombine the plurality of the time-sequential frames of the imagevisualization representation at the same time as the creation andgeneration of the temporally-changing coordinate map into a plurality ofenhanced frames, and the processor is still further configured tocontinually output the enhanced frames to the output component.